Healthcare Provider Details

I. General information

NPI: 1063193779
Provider Name (Legal Business Name): ABRAMOV SERVICES IN ADULT HEALTH NP P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7312 170TH ST
FRESH MEADOWS NY
11366-1347
US

IV. Provider business mailing address

7312 170TH ST
FRESH MEADOWS NY
11366-1347
US

V. Phone/Fax

Practice location:
  • Phone: 917-208-5578
  • Fax:
Mailing address:
  • Phone: 917-208-5578
  • Fax: 718-380-0197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BORIS ABRAMOV
Title or Position: ADULT NURSE PRACTITIONER
Credential: ANP-BC
Phone: 917-208-5578