Provider Demographics
NPI:1053552059
Name:ABOLAFIA, ANTONIO (DIPLOM)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:ABOLAFIA
Suffix:
Gender:M
Credentials:DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LAKE BELLEVUE DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2417
Mailing Address - Country:US
Mailing Address - Phone:425-643-3758
Mailing Address - Fax:425-643-9364
Practice Address - Street 1:1 LAKE BELLEVUE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2417
Practice Address - Country:US
Practice Address - Phone:425-643-3758
Practice Address - Fax:425-643-9364
Is Sole Proprietor?:No
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 60003839171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist