Healthcare Provider Details

I. General information

NPI: 1710035019
Provider Name (Legal Business Name): TOBI ALISSA ABRAMSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 12/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 BROADWAY
HEWLETT NY
11557-1630
US

IV. Provider business mailing address

32 MARION ST
GREENVALE NY
11548-1114
US

V. Phone/Fax

Practice location:
  • Phone: 516-596-0073
  • Fax:
Mailing address:
  • Phone: 516-484-1597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number010847
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: