Provider Demographics
NPI:1689759789
Name:ABRAHAM, SHEEJA K (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEEJA
Middle Name:K
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:1015 CHESTNUT STREET SUITE 601
Practice Address - Street 2:NEMOURS CHILDRENS CLINIC, PHILADELPHIA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4306
Practice Address - Country:US
Practice Address - Phone:215-503-2664
Practice Address - Fax:215-923-0459
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2011-09-19
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Provider Licenses
StateLicense IDTaxonomies
PAMD059230L2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02714249Medicaid
MD4097700Medicaid
NJ7006802Medicaid
DE0001015701Medicaid
PA001596077Medicaid
MD4097700Medicaid
NJ7006802Medicaid