Healthcare Provider Details

I. General information

NPI: 1174044358
Provider Name (Legal Business Name): CHRISTIE ABROMOWICZ LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 DIANE PL
PARAMUS NJ
07652-4601
US

IV. Provider business mailing address

225 DIANE PL
PARAMUS NJ
07652-4601
US

V. Phone/Fax

Practice location:
  • Phone: 201-403-5668
  • Fax:
Mailing address:
  • Phone: 12014035668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00362100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: