Provider Demographics
NPI:1073914453
Name:ABRAHAM, REBECCA (PHARMD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LAUREL DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2919
Mailing Address - Country:US
Mailing Address - Phone:201-851-7155
Mailing Address - Fax:
Practice Address - Street 1:8 E 41ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-0040
Practice Address - Country:US
Practice Address - Phone:718-230-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist