Provider Demographics
NPI:1356665913
Name:ABRAHAM, THOMAS P (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:P
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LOCKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5028
Mailing Address - Country:US
Mailing Address - Phone:914-654-1222
Mailing Address - Fax:914-654-1888
Practice Address - Street 1:110 LOCKWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5028
Practice Address - Country:US
Practice Address - Phone:914-654-1222
Practice Address - Fax:914-654-1888
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist