Edda M Y Abad
Individual provider Active NPI Pediatrics Physician · Ridgewood, NY
NPI 1295768059 · NPPES record last updated Aug 24, 2015
Key facts
- NPI
- 1295768059
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 121306 (NY)
- Practice address
- 6359 Forest Ave
Ridgewood, NY 11385-2070 - Phone
- (718) 366-8042
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121306 | NY | MD | Pediatrics Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 121306 | NY | Yes |
Addresses
Primary practice location
6359 Forest Ave
Ridgewood, NY 11385-2070
Mailing address
6359 Forest Ave
Ridgewood, NY 11385-2070
Phone (718) 366-8042
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00227303 | Medicaid | NY |
Other providers in Ridgewood, NY
- 20 20 Optometry Services, PC
- Pnina Abramov
- Rozalina Abramov
- Abul Shahidullah, M. D., Medical Office
- Accu-Care Physical Therapy Works, P.C.
- Maribel Acevedo
All providers in Ridgewood, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.