Provider Demographics
NPI:1366494684
Name:ABRAHAMS, JOEL P (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:P
Last Name:ABRAHAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 231142
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70183-1142
Mailing Address - Country:US
Mailing Address - Phone:504-734-1740
Mailing Address - Fax:504-455-5718
Practice Address - Street 1:1529 RIVER OAKS RD W
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-2162
Practice Address - Country:US
Practice Address - Phone:504-458-1659
Practice Address - Fax:504-455-5718
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA589103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA290255OtherUBH PROVIDER NUMBER
LA5S329Medicare ID - Type Unspecified