Provider Demographics
NPI:1891799748
Name:ABRAHAM, RAJARATNAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJARATNAM
Middle Name:
Last Name:ABRAHAM
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 1:289 PLEASANT ST
Mailing Address - Street 2:STE 401
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-3005
Mailing Address - Country:US
Mailing Address - Phone:508-679-5888
Mailing Address - Fax:508-679-1059
Practice Address - Street 1:289 PLEASANT ST
Practice Address - Street 2:STE 401
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3005
Practice Address - Country:US
Practice Address - Phone:508-679-5888
Practice Address - Fax:508-679-1059
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37460207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB75264Medicare UPIN
K08292Medicare PIN