Basic Information
Provider Information
NPI: 1891923306
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABAYA
FirstName: RUTH
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 E PENN SQ
Address2: 9TH FL
City: PHILADELPHIA
State: PA
PostalCode: 191073323
CountryCode: US
TelephoneNumber: 2674259234
FaxNumber: 2674259299
Practice Location
Address1: 3401 CIVIC CENTER BLVD
Address2: THE CHILDREN'S HOSPITAL OF PHILADELPHIA
City: PHILADELPHIA
State: PA
PostalCode: 191044319
CountryCode: US
TelephoneNumber: 2155901000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2009
LastUpdateDate: 03/31/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0204XMD446008PAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine

No ID Information.


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