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General NPI Number Information
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NPI Number | 1063714020
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Entity Type | Individual
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Provider Name | ABE RALPH EMILE
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Gender | Male
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Dates
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Enumeration Date | 11/24/2010
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 2079 FOREST AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10303-1865
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Country | US
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Telephone | 718-815-6560
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Fax |
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Provider Business Mailing Address
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Address Line | 2016 E 54TH ST
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City | BROOKLYN
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State | NY
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Zip | 11234-4713
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Country | US
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Telephone | 917-376-0137
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 092748
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License Number State | NY
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