Provider Demographics
NPI:1811072606
Name:ABRAHAM, BARRY B (MD)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:B
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 BOBARN DR
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1149
Mailing Address - Country:US
Mailing Address - Phone:215-435-1801
Mailing Address - Fax:610-672-9803
Practice Address - Street 1:1231 BOBARN DR
Practice Address - Street 2:
Practice Address - City:PENN VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19072-1149
Practice Address - Country:US
Practice Address - Phone:215-435-1801
Practice Address - Fax:610-672-9803
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015281E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C28917Medicare UPIN
PA165051YZU2Medicare PIN
PAP00772109Medicare PIN
C28917Medicare UPIN
PA165051V4BMedicare PIN