Healthcare Provider Details

I. General information

NPI: 1821056201
Provider Name (Legal Business Name): MARTHE ABRAHAM M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARTHE ABRAHAM M.D.

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 SCHENECTADY AVE
BROOKLYN NY
11203-1809
US

IV. Provider business mailing address

982 LYDIA PL MANAGED CARE, 6TH FLOOR - BLUMBERG BLDG
BALDWIN NY
11510-5020
US

V. Phone/Fax

Practice location:
  • Phone: 718-604-5281
  • Fax: 718-604-5468
Mailing address:
  • Phone: 718-604-5281
  • Fax: 718-604-5685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number205003
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: