Healthcare Provider Details

I. General information

NPI: 1013239391
Provider Name (Legal Business Name): DR. TIGI M ABRAHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2010
Last Update Date: 02/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 W MERRICK RD
VALLEY STREAM NY
11580-5512
US

IV. Provider business mailing address

98 JOSEPH ST
NEW HYDE PARK NY
11040-1705
US

V. Phone/Fax

Practice location:
  • Phone: 516-561-1400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number052941-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: