Basic Information
| Provider Information | |||||||||
| NPI: | 1073894226 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABRAHAM | ||||||||
| FirstName: | PUSHPA | ||||||||
| MiddleName: | SIBI | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CPNP, MSN RN CCRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 SOMERSET ST | ||||||||
| Address2: | |||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322587000 | ||||||||
| FaxNumber: | 9083895675 | ||||||||
| Practice Location | |||||||||
| Address1: | 1642 COOL SPRING RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229011379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4342840267 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2011 | ||||||||
| LastUpdateDate: | 07/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | 26NJ00354600 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.