Provider Demographics
NPI:1457693525
Name:ABLEMAN, GENNA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:GENNA
Middle Name:ANNE
Last Name:ABLEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E 106TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-4007
Mailing Address - Country:US
Mailing Address - Phone:212-360-2600
Mailing Address - Fax:212-360-2618
Practice Address - Street 1:212 E 106TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-4007
Practice Address - Country:US
Practice Address - Phone:212-360-2600
Practice Address - Fax:212-360-2618
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY283367208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04531128Medicaid