Provider Demographics
NPI:1750962932
Name:ABRAHAM, ANGEL C (ND)
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:C
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 GREENWAY E
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2246
Mailing Address - Country:US
Mailing Address - Phone:516-754-3688
Mailing Address - Fax:
Practice Address - Street 1:53 BANK ST UNIT 2
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-6708
Practice Address - Country:US
Practice Address - Phone:860-799-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000660175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath