Provider Demographics
NPI:1326218595
Name:ABRAMOV, GREGORY
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:ABRAMOV
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 1:36 A EAST 36TH STREET
Mailing Address - Street 2:SUITE 200-NYOG
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-889-8575
Mailing Address - Fax:212-686-3292
Practice Address - Street 1:36 A EAST 36TH STREET
Practice Address - Street 2:SUITE 200 - NYOG
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-889-8575
Practice Address - Fax:212-686-3292
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002166-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist