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NPI Code Detail

MEDICARE: ANISH G ABRAHAM

MEDICARE: ANISH G ABRAHAM
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
1225XP0019XPhysical Rehabilitation Occupational Therapist116530TX

General Provider Information

NPI Number : 1427555366
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANISH G ABRAHAM
Provider Business Mailing Address
First Line : 308 STONE RIDGE DR
Second Line :
City : SUNNYVALE
State : TX
Zip : 75182-2627
Country : US
Telephone Number : 516-581-9221
Fax Number :
Provider Business Practice Location Address
First Line : 9009 WHITE ROCK TRL
Second Line :
City : DALLAS
State : TX
Zip : 75238-3347
Country : US
Telephone Number : 516-581-9221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2018
Last Update Date : 04/08/2018

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