Provider Demographics
NPI:1346270584
Name:ABRAMS, MARC TODD (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:TODD
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2810
Mailing Address - Country:US
Mailing Address - Phone:914-666-2735
Mailing Address - Fax:914-244-3159
Practice Address - Street 1:91 SMITH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2810
Practice Address - Country:US
Practice Address - Phone:914-666-2735
Practice Address - Fax:914-244-3159
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010443-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010443-1OtherNYS LICENSED PSYCHOLOGIST