Healthcare Provider Details

I. General information

NPI: 1184704819
Provider Name (Legal Business Name): ZVI H ABRAMSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 HABANAI STREET
JERUSALEM IL
96264
IL

IV. Provider business mailing address

40 HABANAI STREET
JERUSALEM IL
96264
IL

V. Phone/Fax

Practice location:
  • Phone: 972-265-1576
  • Fax:
Mailing address:
  • Phone: 972-265-1576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number150258
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: