Provider Demographics
NPI:1356517346
Name:DR. AUDREY ABATEMARCO D.P.M.
Entity type:Organization
Organization Name:DR. AUDREY ABATEMARCO D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PODIATRY MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ABATEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-227-0523
Mailing Address - Street 1:40 MONROE ST
Mailing Address - Street 2:FI3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7793
Mailing Address - Country:US
Mailing Address - Phone:212-227-0523
Mailing Address - Fax:212-842-2451
Practice Address - Street 1:63 CATHERINE ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1307
Practice Address - Country:US
Practice Address - Phone:212-227-0523
Practice Address - Fax:212-842-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003693-2332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPG7301OtherBLUE CROSS BLUE SHIELD
NY0050079OtherGHI
NY10210444OtherAMERIGROUP
NY1314314OtherCOVENTRY HEALTH
NY1345276440005OtherCIGNA
NYP515833OtherOXFORD
NY00877409Medicaid
NY4510217OtherAETNA
NY5798140001OtherDMERC
NY050127000029OtherFIDELIS
NY1314314OtherFIRST HEALTH
NY1345276440005OtherCIGNA
NYP40072Medicare PIN