Provider Demographics
NPI:1902933328
Name:ABBASEY, SALLAH U (MD)
Entity Type:Individual
Prefix:MR
First Name:SALLAH
Middle Name:U
Last Name:ABBASEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3662 CULVERT ROAD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103
Mailing Address - Country:US
Mailing Address - Phone:585-798-3449
Mailing Address - Fax:585-798-8003
Practice Address - Street 1:3662 CULVERT ROAD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103
Practice Address - Country:US
Practice Address - Phone:585-798-3449
Practice Address - Fax:585-798-8003
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105234175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA9595123OtherDEA
BA9595123OtherDEA