MEDICARE: FIDEL ABREU DDS, PLLC

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	1223G0001X	General Practice Dentistry		NY

General Provider Information

NPI Number	:	1093105132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIDEL ABREU DDS, PLLC

Provider Business Mailing Address
First Line	:	80 GUY LOMBARDO AVE
Second Line	:
City	:	FREEPORT
State	:	NY
Zip	:	11520-3715
Country	:	US
Telephone Number	:	516-223-6896
Fax Number	:	516-223-2954

Provider Business Practice Location Address
First Line	:	80 GUY LOMBARDO AVE
Second Line	:
City	:	FREEPORT
State	:	NY
Zip	:	11520-3715
Country	:	US
Telephone Number	:	516-223-6896
Fax Number	:	516-223-2954

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. ANGELA ANDERSON-LOVELL
Credential	:
Telephone Number	:	404-915-5228

Provider Enumeration Date	:	01/28/2015
Last Update Date	:	01/28/2015

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