Provider Demographics
NPI:1588069058
Name:RAFAEL ABRAMOV MEDICAL, P.C.
Entity type:Organization
Organization Name:RAFAEL ABRAMOV MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMOV
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-371-0053
Mailing Address - Street 1:1527 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1628
Mailing Address - Country:US
Mailing Address - Phone:516-371-0053
Mailing Address - Fax:516-537-8787
Practice Address - Street 1:800 2ND AVE
Practice Address - Street 2:SUITE 805
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4709
Practice Address - Country:US
Practice Address - Phone:646-467-2737
Practice Address - Fax:888-591-4915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261232208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty