Provider Demographics
NPI:1407817000
Name:ABRAHAM, BLESSEN (DC)
Entity Type:Individual
Prefix:DR
First Name:BLESSEN
Middle Name:
Last Name:ABRAHAM
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 1:151 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2939
Mailing Address - Country:US
Mailing Address - Phone:732-565-1701
Mailing Address - Fax:732-565-1710
Practice Address - Street 1:151 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2939
Practice Address - Country:US
Practice Address - Phone:732-565-1701
Practice Address - Fax:732-565-1710
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009027111N00000X
NJ38MC00624400111N00000X
NYX010691-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1357356OtherAETNA HMO
PA7500739OtherAETNA PPO