Healthcare Provider Details

I. General information

NPI: 1497837769
Provider Name (Legal Business Name): VADIM ABRAMOV MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 12/18/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CORTELYOU ROAD SUITE 1D
BROOKLYN NY
11218-5284
US

IV. Provider business mailing address

60 BELL POINT DR.
BROOKLYN NY
11234-6328
US

V. Phone/Fax

Practice location:
  • Phone: 718-282-0900
  • Fax: 718-282-0995
Mailing address:
  • Phone: 718-282-0900
  • Fax: 718-282-0995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. VADIM ABRAMOV
Title or Position: OWNER
Credential: MD
Phone: 718-282-0900