Provider Demographics
NPI:1831170976
Name:ABRAHAM, SEENA S (MBBS, FACC, FAAP)
Entity type:Individual
Prefix:DR
First Name:SEENA
Middle Name:S
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MBBS, FACC, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CROSFIELD AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:WEST NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10994-2216
Mailing Address - Country:US
Mailing Address - Phone:845-348-9400
Mailing Address - Fax:845-348-0505
Practice Address - Street 1:2 CROSFIELD AVE STE 208
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2216
Practice Address - Country:US
Practice Address - Phone:845-348-9400
Practice Address - Fax:845-348-0505
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2146922080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0057339OtherNEW JERSEY MEDICAID
NY02374918Medicaid
NJ0057339OtherNEW JERSEY MEDICAID
NY5E6881Medicare ID - Type Unspecified