Provider Demographics
NPI:1174671457
Name:ABRAMOV'S COMPREHENSIVE FOOT CARE PA
Entity Type:Organization
Organization Name:ABRAMOV'S COMPREHENSIVE FOOT CARE PA
Other - Org Name:TATYANA ABRAMOVA DPM.PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMOV
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:443-872-7052
Mailing Address - Street 1:3303 WOODVALLEY DR.
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1956
Mailing Address - Country:US
Mailing Address - Phone:443-872-7052
Mailing Address - Fax:410-400-6085
Practice Address - Street 1:114 SLADE AVE
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4906
Practice Address - Country:US
Practice Address - Phone:443-872-7052
Practice Address - Fax:410-400-6085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01430213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD412287900Medicaid
MD046NMedicare PIN