Provider Demographics
NPI:1275859696
Name:ABRAHAM, GALLANE DABELA (MD)
Entity Type:Individual
Prefix:DR
First Name:GALLANE
Middle Name:DABELA
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GALLANE
Other - Middle Name:
Other - Last Name:DABELA ABRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1400 PELHAM PKWY S
Mailing Address - Street 2:BUILDING 6, 1B25
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1138
Mailing Address - Country:US
Mailing Address - Phone:718-918-5820
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PKWY S
Practice Address - Street 2:BUILDING 6, 1B25
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256549207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine