Provider Demographics
NPI:1740755313
Name:ABRAHAM, MERIN THOMAS (OD)
Entity Type:Individual
Prefix:MRS
First Name:MERIN
Middle Name:THOMAS
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 SOUTH ORANGE AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-322-0100
Mailing Address - Fax:973-322-0102
Practice Address - Street 1:200 SOUTH ORANGE AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-322-0100
Practice Address - Fax:973-322-0102
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00683100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist