Healthcare Provider Details

I. General information

NPI: 1811201007
Provider Name (Legal Business Name): CHARLENE NAOMI ABRAHAM CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 EASTCHESTER RD
BRONX NY
10461-2374
US

IV. Provider business mailing address

1695 EASTCHESTER RD
BRONX NY
10461-2374
US

V. Phone/Fax

Practice location:
  • Phone: 718-405-8200
  • Fax: 718-465-8391
Mailing address:
  • Phone: 718-405-8200
  • Fax: 718-465-8391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number001265
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: