Healthcare Provider Details

I. General information

NPI: 1366494684
Provider Name (Legal Business Name): JOEL P ABRAHAMS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1529 RIVER OAKS RD W
HARAHAN LA
70123-2162
US

IV. Provider business mailing address

PO BOX 231142
NEW ORLEANS LA
70183-1142
US

V. Phone/Fax

Practice location:
  • Phone: 504-458-1659
  • Fax: 504-455-5718
Mailing address:
  • Phone: 504-734-1740
  • Fax: 504-455-5718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number589
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: