MEDICARE: ALEXANDR ABRAMOV MEDICAL PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	203972	NY

General Provider Information

NPI Number	:	1316102445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXANDR ABRAMOV MEDICAL PC

Provider Business Mailing Address
First Line	:	8746 20TH AVE FL 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4802
Country	:	US
Telephone Number	:	718-234-9191
Fax Number	:	718-234-8591

Provider Business Practice Location Address
First Line	:	8746 20TH AVE FL 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4802
Country	:	US
Telephone Number	:	718-234-9191
Fax Number	:	718-234-8591

Authorized Official
Title or Position	:	ADMINISTRATIVE ASSISTANT
Name	:	MS. OLEKSANDRA KOVAL
Credential	:
Telephone Number	:	718-234-9191

Provider Enumeration Date	:	07/29/2008
Last Update Date	:	01/08/2020

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