Provider Demographics
NPI:1578818407
Name:ABRAHAM EGER
Entity Type:Organization
Organization Name:ABRAHAM EGER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:EGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-200-0013
Mailing Address - Street 1:10 HORIZON CT
Mailing Address - Street 2:203
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-7806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 HORIZON CT
Practice Address - Street 2:203
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-7806
Practice Address - Country:US
Practice Address - Phone:845-200-0013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03277149Medicaid