Provider Demographics
NPI:1457511958
Name:ABBENE, DEA E (NP)
Entity Type:Individual
Prefix:
First Name:DEA
Middle Name:E
Last Name:ABBENE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SBUH 15 NORTH
Mailing Address - Street 2:15 NORTH ROOM 082 ZIP 7151
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-7151
Mailing Address - Country:US
Mailing Address - Phone:631-444-1234
Mailing Address - Fax:631-444-1235
Practice Address - Street 1:SBUH 15 NORTH
Practice Address - Street 2:15 NORTH ROOM 082 ZIP 7151
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-7151
Practice Address - Country:US
Practice Address - Phone:631-444-1234
Practice Address - Fax:631-444-1235
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303013363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health