Provider Demographics
NPI:1962595629
Name:ABELLAR, VANJELO P (RPT)
Entity type:Individual
Prefix:MR
First Name:VANJELO
Middle Name:P
Last Name:ABELLAR
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 E COLFAX AVE.
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204
Mailing Address - Country:US
Mailing Address - Phone:732-541-2233
Mailing Address - Fax:732-541-2234
Practice Address - Street 1:1175 ROOSEVELT AVE.
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008
Practice Address - Country:US
Practice Address - Phone:732-541-2233
Practice Address - Fax:732-541-2234
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01194700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00358197OtherRAILROAD MEDICARE
NJ550849160OtherTAX ID
NJ550849160OtherTAX ID