Provider Demographics
NPI:1851673180
Name:ABRAMCHAYEVA, DIANA (MSTOM)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:ABRAMCHAYEVA
Suffix:
Gender:F
Credentials:MSTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6485 WETHEROLE ST
Mailing Address - Street 2:APT #5B
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4067
Mailing Address - Country:US
Mailing Address - Phone:646-318-0880
Mailing Address - Fax:
Practice Address - Street 1:6485 WETHEROLE ST
Practice Address - Street 2:APT #5B
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4067
Practice Address - Country:US
Practice Address - Phone:646-318-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00082400171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist