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1124241872
TRACY IVAN ABRAHAM
BRONX, NY
NPI
1124241872
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: NY 006753-1)
Enumeration Date
2007-04-11
Last Update Date
2007-07-08
Business Address
-- TRACY IVAN ABRAHAM PA
1650 GRAND CONCOURSE
BRONX, NY 10457
Phone number: 718-901-8484
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Mailing Address
-- TRACY IVAN ABRAHAM PA
187 N. BROOKSIDE AVE.
FREEPORT, NY 11520-1928
Phone number: 516-546-2980
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