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General NPI Number Information
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NPI Number | 1952097248
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Entity Type | Individual
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Provider Name | DR. JOAZ BABU ABRAHAM
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Gender | Male
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 49 MOUNT PLEASANT AVE
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City | WEST ORANGE
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State | NJ
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Zip | 07052-4901
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Country | US
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Telephone | 973-325-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 18 W BLACKWELL ST
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City | DOVER
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State | NJ
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Zip | 07801-3841
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Country | US
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Telephone | 973-328-3344
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI03010500
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License Number State | NJ
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