Provider Demographics
NPI:1194050427
Name:ABATE, BETELEHEM (NP)
Entity type:Individual
Prefix:
First Name:BETELEHEM
Middle Name:
Last Name:ABATE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14625 BALTIMORE AVE STE 465
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4902
Mailing Address - Country:US
Mailing Address - Phone:240-447-9995
Mailing Address - Fax:240-363-0063
Practice Address - Street 1:6910 MAYFAIR ROAD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-2070
Practice Address - Country:US
Practice Address - Phone:443-683-5884
Practice Address - Fax:240-363-0063
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCRN965723363LA2200X
MDR166533363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health