Healthcare Provider Details

I. General information

NPI: 1831170976
Provider Name (Legal Business Name): SEENA S ABRAHAM MBBS, FACC, FAAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CROSFIELD AVE STE 208
WEST NYACK NY
10994-2216
US

IV. Provider business mailing address

2 CROSFIELD AVE STE 208
WEST NYACK NY
10994-2216
US

V. Phone/Fax

Practice location:
  • Phone: 845-348-9400
  • Fax: 845-348-0505
Mailing address:
  • Phone: 845-348-9400
  • Fax: 845-348-0505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number214692
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: