Provider Demographics
NPI:1487181822
Name:ABRAHAM, ANDREW CRAIG (ATC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:CRAIG
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1940
Mailing Address - Country:US
Mailing Address - Phone:774-279-8894
Mailing Address - Fax:
Practice Address - Street 1:200 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003-9254
Practice Address - Country:US
Practice Address - Phone:413-545-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer