Provider Demographics
NPI:1568422574
Name:ABRAMOVICH, GALINA (MD DO)
Entity Type:Individual
Prefix:MRS
First Name:GALINA
Middle Name:
Last Name:ABRAMOVICH
Suffix:
Gender:F
Credentials:MD DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68-60 AUSTIN STREET
Mailing Address - Street 2:STORE 10
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-997-7100
Mailing Address - Fax:347-252-6261
Practice Address - Street 1:6860 AUSTIN STREET
Practice Address - Street 2:STORE 10
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4245
Practice Address - Country:US
Practice Address - Phone:718-997-7100
Practice Address - Fax:347-252-6261
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02240568Medicaid
H59605Medicare UPIN
NY02240568Medicaid