Provider Demographics
NPI:1003808304
Name:AVRAHAM, OVADYAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:OVADYAH
Middle Name:
Last Name:AVRAHAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2965 CROPSEY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-7216
Mailing Address - Country:US
Mailing Address - Phone:718-266-2845
Mailing Address - Fax:718-372-7445
Practice Address - Street 1:2965 CROPSEY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-7216
Practice Address - Country:US
Practice Address - Phone:718-266-2845
Practice Address - Fax:718-372-7445
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY91069841835G0303X
NY049943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric