Provider Demographics
NPI:1437611779
Name:ABRAHAM, ELITA M (SPECIAL ED)
Entity Type:Individual
Prefix:
First Name:ELITA
Middle Name:M
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:SPECIAL ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 38TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3612
Mailing Address - Country:US
Mailing Address - Phone:718-686-3700
Mailing Address - Fax:718-686-2395
Practice Address - Street 1:8503 RADNOR ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-2325
Practice Address - Country:US
Practice Address - Phone:917-450-9120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist