Provider Demographics
NPI:1376147066
Name:ABRAHAM, SNEHA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SNEHA
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 ACORN PARK DR APT 4105
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1443
Mailing Address - Country:US
Mailing Address - Phone:781-786-1503
Mailing Address - Fax:
Practice Address - Street 1:550 ARSENAL ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2853
Practice Address - Country:US
Practice Address - Phone:617-924-5987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57968183500000X
MAPH236043183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist