Healthcare Provider Details

I. General information

NPI: 1588579064
Provider Name (Legal Business Name): OGUSTA ABRAHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 DAN RD
CANTON MA
02021-2852
US

IV. Provider business mailing address

45 DAN RD
CANTON MA
02021-2852
US

V. Phone/Fax

Practice location:
  • Phone: 774-218-9893
  • Fax:
Mailing address:
  • Phone: 774-218-9893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: