Provider Demographics
NPI:1740802321
Name:WAHBA, ABRAM (MD)
Entity Type:Individual
Prefix:
First Name:ABRAM
Middle Name:
Last Name:WAHBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 JAMES STREET
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:732-321-7010
Mailing Address - Fax:732-632-1584
Practice Address - Street 1:65 JAMES STREET
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:732-321-7010
Practice Address - Fax:732-632-1584
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2022-03-17
Deactivation Date:2022-01-17
Deactivation Code:
Reactivation Date:2022-03-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program