Provider Demographics
NPI:1992434922
Name:ABRAMOVIC, DURDICA
Entity type:Individual
Prefix:
First Name:DURDICA
Middle Name:
Last Name:ABRAMOVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 DAVIS AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6397
Mailing Address - Country:US
Mailing Address - Phone:203-274-3615
Mailing Address - Fax:
Practice Address - Street 1:174 DAVIS AVE APT 3A
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6397
Practice Address - Country:US
Practice Address - Phone:203-274-3615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2901689766103TS0200X
NY2977368103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool