Provider Demographics
NPI:1366691495
Name:ABRISHAMIAN, NICOLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:
Last Name:ABRISHAMIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 ROUTE 24
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-2918
Mailing Address - Country:US
Mailing Address - Phone:908-879-2800
Mailing Address - Fax:908-879-1385
Practice Address - Street 1:385 ROUTE 24
Practice Address - Street 2:SUITE 3C
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2918
Practice Address - Country:US
Practice Address - Phone:908-879-2800
Practice Address - Fax:908-879-1385
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00377800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU56133Medicare UPIN