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General NPI Number Information
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NPI Number | 1699952671
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Entity Type | Individual
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Provider Name | LISA P ABRAHAM MD
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Gender | Female
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 110 CHADWICK SQUARE CT STE A
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-3238
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Country | US
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Telephone | 828-698-8135
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Fax | 828-698-8518
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Provider Business Mailing Address
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Address Line | 711 TROY SCHENECTADY RD SUITE 203
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City | LATHAM
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State | NY
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Zip | 12110-2442
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Country | US
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Telephone | 518-782-3700
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Fax | 518-782-3799
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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 | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number | 2018-00393
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 256386
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2018-00393
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 2018-00393
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License Number State | NC
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