Provider Demographics
NPI:1013451806
Name:ABRAKHIMORA, LIO (REGISTERED NURSE RN)
Entity Type:Individual
Prefix:MRS
First Name:LIO
Middle Name:
Last Name:ABRAKHIMORA
Suffix:
Gender:F
Credentials:REGISTERED NURSE RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 JERUSALEM AVENUE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 JERUSALEM AVENUE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801
Practice Address - Country:US
Practice Address - Phone:516-326-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY453406-1163WC0200X, 163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine