Provider Demographics
NPI:1164524617
Name:ABRAMS, CLEMENT WOOLRIDGE PHILIP
Entity Type:Individual
Prefix:MR
First Name:CLEMENT
Middle Name:WOOLRIDGE PHILIP
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 FENIMORE ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-5905
Mailing Address - Country:US
Mailing Address - Phone:718-363-2982
Mailing Address - Fax:
Practice Address - Street 1:15028 UNION TPKE
Practice Address - Street 2:SUITE 50
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3900
Practice Address - Country:US
Practice Address - Phone:718-969-7668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000022262237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist