Healthcare Provider Details

I. General information

NPI: 1275608341
Provider Name (Legal Business Name): ANTOINE TONY ABED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 W 125TH ST GROUND FLOOR
NEW YORK NY
10027-4820
US

IV. Provider business mailing address

374 W 125TH ST GROUND FLOOR
NEW YORK NY
10027-4820
US

V. Phone/Fax

Practice location:
  • Phone: 212-749-7960
  • Fax: 212-663-7235
Mailing address:
  • Phone: 212-749-7960
  • Fax: 212-663-7235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number182478
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: