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NPI Code Detail

MEDICARE: GINCY ABRAHAM

MEDICARE: GINCY 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
1183500000XPharmacist047431-1NY

General Provider Information

NPI Number : 1699098673
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINCY ABRAHAM
Provider Business Mailing Address
First Line : 2095 DUTCH BROADWAY
Second Line :
City : ELMONT
State : NY
Zip : 11004
Country : US
Telephone Number : 516-285-4214
Fax Number : 516-285-3951
Provider Business Practice Location Address
First Line : 2095 DUTCH BROADWAY
Second Line :
City : ELMONT
State : NY
Zip : 11003-4247
Country : US
Telephone Number : 516-285-4214
Fax Number : 516-285-3951
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2010
Last Update Date : 03/05/2010

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Directions to “ GINCY ABRAHAM ” Practice Location

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