Healthcare Provider Details

I. General information

NPI: 1477999522
Provider Name (Legal Business Name): NICOLAS JULIAN ABREU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2013
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E 41ST ST
NEW YORK NY
10017-6739
US

IV. Provider business mailing address

222 E 41ST ST
NEW YORK NY
10017-6739
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-8344
  • Fax: 212-263-8310
Mailing address:
  • Phone: 212-263-8344
  • Fax: 212-263-8310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number311354
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number311354
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number311354
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: