Provider Demographics
NPI:1538292925
Name:ABRAMOVA, NELYA (PHARM D)
Entity Type:Individual
Prefix:
First Name:NELYA
Middle Name:
Last Name:ABRAMOVA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14733 76TH AVE APT 2C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3157
Mailing Address - Country:US
Mailing Address - Phone:917-977-0341
Mailing Address - Fax:
Practice Address - Street 1:14919 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3849
Practice Address - Country:US
Practice Address - Phone:718-380-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050663-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY050663-1OtherNYS LICENSE NUMBER