Provider Demographics
NPI:1184016339
Name:ABRAHAM, SOFIYA
Entity Type:Individual
Prefix:
First Name:SOFIYA
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BISHOP ST
Mailing Address - Street 2:304
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8337
Mailing Address - Country:US
Mailing Address - Phone:203-565-5205
Mailing Address - Fax:
Practice Address - Street 1:4 BISHOP ST
Practice Address - Street 2:304
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8337
Practice Address - Country:US
Practice Address - Phone:203-565-5205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH234351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist