Provider Demographics
NPI:1205080306
Name:BRAM, ARTHUR IRWIN
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:IRWIN
Last Name:BRAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MAPLESHADE LN
Mailing Address - Street 2:STONY BROOK
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2805
Mailing Address - Country:US
Mailing Address - Phone:631-682-8197
Mailing Address - Fax:
Practice Address - Street 1:17 MAPLESHADE LN
Practice Address - Street 2:STONY BROOK
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2805
Practice Address - Country:US
Practice Address - Phone:631-682-8197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst