Provider Demographics
NPI:1376700443
Name:ABOLA, RAMON E (MD)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:E
Last Name:ABOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STONY BROOK ANAESTHESIOLOGY UFPC
Mailing Address - Street 2:PO BOX 1559
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-444-2975
Mailing Address - Fax:
Practice Address - Street 1:STONY BROOK UNIVERISTY MEDICAL CTR
Practice Address - Street 2:100 NICHOLS ROAD, HSC, L4, RM 060
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8480
Practice Address - Country:US
Practice Address - Phone:631-444-2975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249356207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology