Healthcare Provider Details

I. General information

NPI: 1891180196
Provider Name (Legal Business Name): NADIA YASMIN ABIDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2015
Last Update Date: 04/28/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ST LUKES BLVD
EASTON PA
18045-5671
US

IV. Provider business mailing address

911 PARK AVE APT 1A
NEW YORK NY
10075-0385
US

V. Phone/Fax

Practice location:
  • Phone: 484-503-7546
  • Fax:
Mailing address:
  • Phone: 212-772-7724
  • Fax: 212-517-9566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberMD470722
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberMD470722
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: