Provider Demographics
NPI:1831336619
Name:ABDOU, MARIA C (RPH)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:ABDOU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BERMUDA RD
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:NY
Mailing Address - Zip Code:13492-2206
Mailing Address - Country:US
Mailing Address - Phone:315-732-6915
Mailing Address - Fax:315-732-6641
Practice Address - Street 1:704 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1406
Practice Address - Country:US
Practice Address - Phone:315-732-6915
Practice Address - Fax:315-732-6641
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037978-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist