Provider Demographics
NPI:1356674824
Name:ABRAMS, COLEEN K (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:COLEEN
Middle Name:K
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TELEPORT DR STE 207
Mailing Address - Street 2:CORPORATE COMMONS TWO
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10311-1004
Mailing Address - Country:US
Mailing Address - Phone:718-273-5500
Mailing Address - Fax:718-273-3232
Practice Address - Street 1:2 TELEPORT DR STE 207
Practice Address - Street 2:CORPORATE COMMONS TWO
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10311-1004
Practice Address - Country:US
Practice Address - Phone:718-273-5500
Practice Address - Fax:718-273-3232
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010358363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical