Provider Demographics
NPI:1437174703
Name:ABRAMSON, LESLIE S (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:S
Last Name:ABRAMSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:93 PILGRIM PARK RD STE 6
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676-1729
Mailing Address - Country:US
Mailing Address - Phone:802-241-1141
Mailing Address - Fax:802-241-2492
Practice Address - Street 1:93 PILGRIM PARK RD STE 6
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676-1729
Practice Address - Country:US
Practice Address - Phone:802-241-1141
Practice Address - Fax:802-241-2492
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT04200068782080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1255673109Medicaid
NYA92061Medicaid
VT0005598Medicaid
VT1437174703Medicaid
VTA92061Medicare UPIN
VT1437174703Medicaid