Provider Demographics
NPI:1588835193
Name:ABRAHAM, TRINA II (OTA/L)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:ABRAHAM
Suffix:II
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 UNION ST
Mailing Address - Street 2:APT. 1D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-1159
Mailing Address - Country:US
Mailing Address - Phone:347-243-0052
Mailing Address - Fax:
Practice Address - Street 1:460 WEST 34TH STREET
Practice Address - Street 2:9TH FLOOR PREMIER HEALTH CARE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1002
Practice Address - Country:US
Practice Address - Phone:212-273-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-23
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006972-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY006972-1OtherLICENSE NUMBER