Healthcare Provider Details

I. General information

NPI: 1407855489
Provider Name (Legal Business Name): AVRAM L. ABRAMOWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 06/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 60 UNION TPKE SUITE 360
FRESH MEADOWS NY
11366
US

IV. Provider business mailing address

176 60 UNION TPKE SUITE 360
FRESH MEADOWS NY
11366
US

V. Phone/Fax

Practice location:
  • Phone: 718-460-2300
  • Fax: 718-460-9697
Mailing address:
  • Phone: 718-460-2300
  • Fax: 718-460-9697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number170441
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number170441-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: