Healthcare Provider Details

I. General information

NPI: 1528141892
Provider Name (Legal Business Name): BETH PHYLLIS ABRAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HOLLAND AVE STRATTON VA MEDICAL CENTER
ALBANY NY
12208-3410
US

IV. Provider business mailing address

113 HOLLAND AVE STRATTON VA MEDICAL CENTER
ALBANY NY
12208-3410
US

V. Phone/Fax

Practice location:
  • Phone: 518-626-5000
  • Fax:
Mailing address:
  • Phone: 518-626-5327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number167929
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number167929
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: