Healthcare Provider Details

I. General information

NPI: 1104992718
Provider Name (Legal Business Name): OSCAR ABRAHAM L.AC., L.M.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 E 12TH ST
BROOKLYN NY
11230-3607
US

IV. Provider business mailing address

955 E 12TH ST
BROOKLYN NY
11230-3607
US

V. Phone/Fax

Practice location:
  • Phone: 718-258-1829
  • Fax: 718-677-9485
Mailing address:
  • Phone: 718-258-1829
  • Fax: 718-677-9485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number003995
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number012347
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00053400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: