Provider Demographics
NPI:1003582669
Name:ABRAHAM, KARAN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:KARAN
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LONGWOOD AVE, BOSTON CHILDREN'S HOSPITAL
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-355-7681
Mailing Address - Fax:617-730-0469
Practice Address - Street 1:300 LONGWOOD AVE, BOSTON CHILDREN'S HOSPITAL
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-7681
Practice Address - Fax:617-730-0469
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2023-03-01
Deactivation Date:2022-12-19
Deactivation Code:
Reactivation Date:2023-03-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program