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General NPI Number Information
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NPI Number | 1174723647
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Entity Type | Organization
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Legal Business Name | ABRAHAM MITTELMAN, MD, LLC
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 3010 WESTCHESTER AVE SUITE 100
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City | PURCHASE
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State | NY
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Zip | 10577-2535
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Country | US
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Telephone | 914-701-0001
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Fax | 914-701-0002
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Provider Business Mailing Address
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Address Line | 3010 WESTCHESTER AVE SUITE 100
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City | PURCHASE
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State | NY
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Zip | 10577-2535
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Country | US
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Telephone | 914-701-0001
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Fax | 914-701-0002
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Authorized Official
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Title or Position | OWNER
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Name | DR. ABRAHAM MITTELMAN
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Credential | MD
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Telephone | 914-681-0025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 136251
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License Number State | NY
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