Provider Demographics
NPI:1033441332
Name:ABRAMOV, MAYRAM (PHD)
Entity type:Individual
Prefix:MRS
First Name:MAYRAM
Middle Name:
Last Name:ABRAMOV
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6612 102ND ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4524
Mailing Address - Country:US
Mailing Address - Phone:347-622-2946
Mailing Address - Fax:
Practice Address - Street 1:773 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8531
Practice Address - Country:US
Practice Address - Phone:347-622-2946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0538201835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy