Provider Demographics
NPI:1033262332
Name:KADISH, ABRAHAM J (DMD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:J
Last Name:KADISH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LORRAINE RD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-1910
Mailing Address - Country:US
Mailing Address - Phone:908-273-2622
Mailing Address - Fax:
Practice Address - Street 1:1395 ST RTE 23
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-1736
Practice Address - Country:US
Practice Address - Phone:973-492-8100
Practice Address - Fax:973-492-0806
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ080891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice