Provider Demographics
NPI:1558315614
Name:ABRAMOVICH, VALERY H (MD)
Entity Type:Individual
Prefix:
First Name:VALERY
Middle Name:H
Last Name:ABRAMOVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:250 HAMMOND POND PKWY
Mailing Address - Street 2:APT.915N
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1533
Mailing Address - Country:US
Mailing Address - Phone:617-816-6103
Mailing Address - Fax:617-467-5262
Practice Address - Street 1:10 LANGLEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-1972
Practice Address - Country:US
Practice Address - Phone:617-879-0055
Practice Address - Fax:617-467-5262
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA786352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3120201Medicaid
MAJ14409Medicare ID - Type Unspecified
MA3120201Medicaid