Provider Demographics
NPI:1386693968
Name:ABELLA, ROMEO S (MD)
Entity type:Individual
Prefix:DR
First Name:ROMEO
Middle Name:S
Last Name:ABELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROMEO
Other - Middle Name:S
Other - Last Name:ABELLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:915 W CAYUGA ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19124
Mailing Address - Country:US
Mailing Address - Phone:215-743-2250
Mailing Address - Fax:215-743-4899
Practice Address - Street 1:915 E CAYUGA ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19124-3817
Practice Address - Country:US
Practice Address - Phone:215-743-2250
Practice Address - Fax:215-743-4899
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032542L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000627160Medicaid
J1744OtherAMERI HEALTH
10842190OtherELDER HEALTH
100129OtherKEYSTONE MERCY
0053790001OtherKEYSTONE
PA0956215OtherAETNA
PA0956215OtherAETNA
PA000627160Medicaid