Provider Demographics
NPI:1790969863
Name:ABRAMS, TRACEE RAE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRACEE
Middle Name:RAE
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-1850
Mailing Address - Country:US
Mailing Address - Phone:845-295-5456
Mailing Address - Fax:845-295-5458
Practice Address - Street 1:267 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-1850
Practice Address - Country:US
Practice Address - Phone:845-295-5456
Practice Address - Fax:845-295-5458
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049681183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist