Provider Demographics
NPI:1184966269
Name:ABRAHAM, JOHN V (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:V
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HEADDEN DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3107
Mailing Address - Country:US
Mailing Address - Phone:845-425-2881
Mailing Address - Fax:
Practice Address - Street 1:464 ELIZABETH AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5116
Practice Address - Country:US
Practice Address - Phone:732-271-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RJ04482183500000X
NJ28RI03533700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist