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Individual

MARK ABIAH STEPHEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
18507 64TH AVE BSMT MEDICAL, FRESH MEADOWS, NY 11365-2707
(347) 368-6222
(347) 368-6291
Mailing address
18507 64TH AVE BSMT MEDICAL, FRESH MEADOWS, NY 11365-2707
(347) 368-6222
(347) 368-6291

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
290169
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1275912495
NY
Enumeration date
05/20/2015
Last updated
12/25/2024
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