Provider Demographics
NPI:1154441723
Name:JAMES V ABRAHAM
Entity Type:Organization
Organization Name:JAMES V ABRAHAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:V
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-777-8121
Mailing Address - Street 1:124 GREGORY AVE
Mailing Address - Street 2:UNIT 301
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4856
Mailing Address - Country:US
Mailing Address - Phone:973-777-8121
Mailing Address - Fax:973-777-3622
Practice Address - Street 1:124 GREGORY AVE
Practice Address - Street 2:UNIT 301
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4856
Practice Address - Country:US
Practice Address - Phone:973-777-8121
Practice Address - Fax:973-777-3622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05604700207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ97794OtherAMERIGROUP
NJ2596704OtherGHI
NJ3838451-002OtherCIGNA
NJ01000347100OtherAMERICHOICE-INT. MED.
NJ3838451-003OtherCIGNA-PULMONARY
NJ01000347101OtherAMERICHOICE-PULMONARY
NJ01000347102OtherAMERICHOICE-CRITICAL CARE
NJ4123649BOtherCIGNA
NJ1948961OtherUNITED HEALTH CARE
NJ23J392OtherEMPIRE BCBS
NJ7149036OtherAETNA - CRITICAL CARE
NJP2023783OtherOXFORD
NJ02176169000OtherAMERIHEALTH
NJ2681928OtherAETNA
NJ7489901Medicaid
NJ4123649BOtherCIGNA
NJ2596704OtherGHI
NJ3838451-003OtherCIGNA-PULMONARY