Provider Demographics
NPI:1124599931
Name:ABRAMSON, BRACHA ROBIN (RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:BRACHA
Middle Name:ROBIN
Last Name:ABRAMSON
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:MS
Other - First Name:BRACHA
Other - Middle Name:ROBIN
Other - Last Name:GOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, CDN
Mailing Address - Street 1:607 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5220
Mailing Address - Country:US
Mailing Address - Phone:917-603-2021
Mailing Address - Fax:
Practice Address - Street 1:607 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5220
Practice Address - Country:US
Practice Address - Phone:917-603-2021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86035373133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered