MEDICARE: DR. JEROME ABELLANA CARIASO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	215615	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477570323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEROME ABELLANA CARIASO MD

Provider Business Mailing Address
First Line	:	141 ROCKY MOUNTAIN RD
Second Line	:
City	:	SOUTHBURY
State	:	CT
Zip	:	06488-2727
Country	:	US
Telephone Number	:	646-481-6488
Fax Number	:	212-656-1601

Provider Business Practice Location Address
First Line	:	521 BERGEN AVE FL 1
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-4010
Country	:	US
Telephone Number	:	718-742-8550
Fax Number	:	718-742-7321

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	12/29/2025

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