Individual provider · Type 1 NPI

Tracy Ivan Abraham, PA

Surgical Physician Assistant · Bronx, NY

NPI number 1124241872 Active

Practice location

1650 Grand Concourse
Bronx, NY 10457

Mailing address

187 N. Brookside Ave.
Freeport, NY 11520-1928

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X006753-1 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1124241872

Tracy Ivan Abraham, PA's National Provider Identifier is 1124241872, issued on Apr 11, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Bronx, NY. The record was last updated on Jul 8, 2007.