Provider Demographics
NPI:1508647348
Name:ABRAMOVITZ, YAAKOV (PSYD)
Entity Type:Individual
Prefix:
First Name:YAAKOV
Middle Name:
Last Name:ABRAMOVITZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 RUTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2923
Mailing Address - Country:US
Mailing Address - Phone:646-580-1749
Mailing Address - Fax:
Practice Address - Street 1:116 W 23RD ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2599
Practice Address - Country:US
Practice Address - Phone:646-580-1749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP125014390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program