Provider Demographics
NPI:1023313871
Name:ABRAMOVICH, BELLA
Entity type:Individual
Prefix:
First Name:BELLA
Middle Name:
Last Name:ABRAMOVICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PARK AVE
Mailing Address - Street 2:APT 9R
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5339
Mailing Address - Country:US
Mailing Address - Phone:917-817-3920
Mailing Address - Fax:
Practice Address - Street 1:4 PARK AVE
Practice Address - Street 2:APT 9R
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5339
Practice Address - Country:US
Practice Address - Phone:917-817-3920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY825503252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency