Provider Demographics
NPI:1013910025
Name:ABRAHAMSON, JULIE LAUREN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LAUREN
Last Name:ABRAHAMSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HOPEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1376
Mailing Address - Country:US
Mailing Address - Phone:914-391-6205
Mailing Address - Fax:
Practice Address - Street 1:1110 STATE ROUTE 55 STE 107
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-5048
Practice Address - Country:US
Practice Address - Phone:845-486-4572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047352122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY223773330Medicare UPIN