Provider Demographics
NPI:1992148118
Name:ABRAMOFF, BENJAMIN A (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:A
Last Name:ABRAMOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:1 GROUND WHITE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-893-2600
Mailing Address - Fax:215-349-8944
Practice Address - Street 1:3400 SPRUCE ST
Practice Address - Street 2:1 GROUND WHITE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-893-2600
Practice Address - Fax:215-349-8944
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD464732208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation