Provider Demographics
NPI:1205691151
Name:ABROMEIT, FREDERICK (HIS)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:
Last Name:ABROMEIT
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 S RIVER ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:HAILEY
Mailing Address - State:ID
Mailing Address - Zip Code:83333-8436
Mailing Address - Country:US
Mailing Address - Phone:208-806-2026
Mailing Address - Fax:208-725-6033
Practice Address - Street 1:221 S RIVER ST STE 1B
Practice Address - Street 2:
Practice Address - City:HAILEY
Practice Address - State:ID
Practice Address - Zip Code:83333-8436
Practice Address - Country:US
Practice Address - Phone:208-806-2026
Practice Address - Fax:208-725-6033
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHA-4655237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist