Provider Demographics
NPI:1316102445
Name:ALEXANDR ABRAMOV MEDICAL PC
Entity type:Organization
Organization Name:ALEXANDR ABRAMOV MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:OLEKSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-234-9191
Mailing Address - Street 1:8746 20TH AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4802
Mailing Address - Country:US
Mailing Address - Phone:718-234-9191
Mailing Address - Fax:718-234-8591
Practice Address - Street 1:8746 20TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4802
Practice Address - Country:US
Practice Address - Phone:718-234-9191
Practice Address - Fax:718-234-8591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203972208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty