Provider Demographics
NPI:1104413780
Name:ABRAMOV, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ABRAMOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1268 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5241
Mailing Address - Country:US
Mailing Address - Phone:718-686-3400
Mailing Address - Fax:718-686-4400
Practice Address - Street 1:1268 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5241
Practice Address - Country:US
Practice Address - Phone:718-686-3400
Practice Address - Fax:718-686-4400
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor