Provider Demographics
NPI:1093725715
Name:WINTER, ABRAHAM T (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:T
Last Name:WINTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 35 QUEENS BLVD
Mailing Address - Street 2:STE 1D
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:718-672-4888
Mailing Address - Fax:716-672-7086
Practice Address - Street 1:86 35 QUEENS BLVD
Practice Address - Street 2:STE 1D
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-672-4888
Practice Address - Fax:716-672-7086
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMD080667207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
29532Medicare ID - Type Unspecified
B58630Medicare UPIN