Provider Demographics
NPI:1508987892
Name:ABRAMOV, RONNEN (DO, MS)
Entity Type:Individual
Prefix:DR
First Name:RONNEN
Middle Name:
Last Name:ABRAMOV
Suffix:
Gender:M
Credentials:DO, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PLAINSBORO RD STE 390
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1916
Mailing Address - Country:US
Mailing Address - Phone:609-497-4371
Mailing Address - Fax:609-497-4379
Practice Address - Street 1:5 PLAINSBORO RD STE 390
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1916
Practice Address - Country:US
Practice Address - Phone:609-497-4371
Practice Address - Fax:609-497-4379
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08565700207LP2900X
PAOS0147172081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0203874Medicaid
PA1023367450001Medicaid
NJ0203874Medicaid