Provider Demographics
NPI:1316109549
Name:ABRAHAM, DARA BETH (DO)
Entity type:Individual
Prefix:
First Name:DARA
Middle Name:BETH
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1722 SYLVAN LN
Mailing Address - Street 2:
Mailing Address - City:GLADWYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19035-1221
Mailing Address - Country:US
Mailing Address - Phone:610-686-9161
Mailing Address - Fax:610-273-5562
Practice Address - Street 1:1601 WALNUT ST STE 1128
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2913
Practice Address - Country:US
Practice Address - Phone:610-686-9161
Practice Address - Fax:610-273-5562
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS0151132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty