Provider Demographics
NPI:1770651572
Name:ABRAHAM, VEENA S (MD)
Entity Type:Individual
Prefix:
First Name:VEENA
Middle Name:S
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HORIZON DR
Mailing Address - Street 2:PEDERSON KRAG CTR
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-920-8000
Mailing Address - Fax:631-920-8165
Practice Address - Street 1:790 PARK AVE
Practice Address - Street 2:STEPPING STONE CDT FAMILY SERVICE LEAGUE
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-427-4001
Practice Address - Fax:631-427-1778
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1781522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00665283Medicaid
92F351Medicare ID - Type Unspecified
NY00665283Medicaid