Provider Demographics
NPI:1912646530
Name:ABAZI, ALBANA
Entity Type:Individual
Prefix:
First Name:ALBANA
Middle Name:
Last Name:ABAZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 19TH AVE APT B2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-2358
Mailing Address - Country:US
Mailing Address - Phone:347-656-0024
Mailing Address - Fax:
Practice Address - Street 1:8201 19TH AVE APT B2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2358
Practice Address - Country:US
Practice Address - Phone:347-656-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02905700122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice