Provider Demographics
NPI:1598060865
Name:ABRAMOV, POLINA (MSED, TSHH)
Entity Type:Individual
Prefix:
First Name:POLINA
Middle Name:
Last Name:ABRAMOV
Suffix:
Gender:F
Credentials:MSED, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 AVENUE X APT 3G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4227
Mailing Address - Country:US
Mailing Address - Phone:646-322-1123
Mailing Address - Fax:
Practice Address - Street 1:1230 AVENUE X APT 3G
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4227
Practice Address - Country:US
Practice Address - Phone:646-322-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist