Provider Demographics
NPI:1104809664
Name:ABRAHAM, RONALD D (DO)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:D
Last Name:ABRAHAM
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E STREET RD
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7711
Mailing Address - Country:US
Mailing Address - Phone:215-322-2777
Mailing Address - Fax:215-322-1713
Practice Address - Street 1:325 E STREET RD
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE
Practice Address - State:PA
Practice Address - Zip Code:19053-7711
Practice Address - Country:US
Practice Address - Phone:215-322-2777
Practice Address - Fax:215-322-1713
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002681L208100000X
NJ25MB23292000208100000X
PAKO000034L208100000X
FLOS2470208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000593571-0011Medicaid
PA0005935710006Medicaid
B95778Medicare UPIN
PA250002477Medicare PIN
NJ017287R90Medicare PIN
PA000593571-0011Medicaid
PA000011YA0XMedicare PIN