MEDICARE: DR. SONIA THOMAS ABRAHAM DDS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DI02244900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	60015441	OTHER	NJ	HORIZON MANAGED CARE

General Provider Information

NPI Number	:	1457332306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONIA THOMAS ABRAHAM DDS

Provider Business Mailing Address
First Line	:	3155 STATE ROUTE 10
Second Line	:	SUITE 111
City	:	DENVILLE
State	:	NJ
Zip	:	07834-3492
Country	:	US
Telephone Number	:	973-328-4434
Fax Number	:

Provider Business Practice Location Address
First Line	:	3155 STATE ROUTE 10
Second Line	:	SUITE 111
City	:	DENVILLE
State	:	NJ
Zip	:	07834-3492
Country	:	US
Telephone Number	:	973-328-4434
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	08/31/2023

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