=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285581314
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | IMANI SARAI ABREU
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2026
-----------------------------------------------------
Last Update Date | 03/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4238 MERRICK RD
-----------------------------------------------------
City | MASSAPEQUA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11758-6016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-794-1644
-----------------------------------------------------
Fax | 516-900-1978
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 FORD DR S
-----------------------------------------------------
City | MASSAPEQUA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11758-3717
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-701-6565
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | N33850
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------