Healthcare Provider Details

I. General information

NPI: 1942785134
Provider Name (Legal Business Name): SNEHA PAKKALLIL ABRAHAM RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 10/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 EAST 23RD STREET RESPIRATORY CARE SERVICES ROOM 13090S
NEW YORK NY
10010
US

IV. Provider business mailing address

423 EAST 23RTD STREET RESPIRATORY CARE SERVICES ROOM 13090S
NEW YORK NY
10010
US

V. Phone/Fax

Practice location:
  • Phone: 212-686-7500
  • Fax: 212-951-6882
Mailing address:
  • Phone: 212-686-7500
  • Fax: 212-951-6882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number007966
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: