Provider Demographics
NPI:1487258679
Name:ABRAMO, NICHOLAS WILLIAM
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:WILLIAM
Last Name:ABRAMO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462-1220
Mailing Address - Country:US
Mailing Address - Phone:978-582-7013
Mailing Address - Fax:
Practice Address - Street 1:333 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462-1220
Practice Address - Country:US
Practice Address - Phone:978-582-7013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist