Healthcare Provider Details

I. General information

NPI: 1376477380
Provider Name (Legal Business Name): JEBY ABRAHAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ST. CATHERINE OF SIENA HOSPITAL 50 ROUTE 25 A
SMITHTOWN NY
11787
US

IV. Provider business mailing address

GOOD SAMARITAN UNIVERSITY HOSPITAL 1000 MONTAUK HIGHWAY
WEST LSLIP NY
11795
US

V. Phone/Fax

Practice location:
  • Phone: 631-862-3748
  • Fax:
Mailing address:
  • Phone:
  • Fax: 631-376-3420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: