Healthcare Provider Details

I. General information

NPI: 1689239659
Provider Name (Legal Business Name): ARTHUR ABRAMOV
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2019
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14108 JEWEL AVE
FLUSHING NY
11367-1618
US

IV. Provider business mailing address

13610 LATIMER PL
FLUSHING NY
11354-2937
US

V. Phone/Fax

Practice location:
  • Phone: 718-791-8906
  • Fax:
Mailing address:
  • Phone: 718-791-8906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number012620
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01025300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: