Basic Information
| Provider Information | |||||||||
| NPI: | 1265829667 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABROMS | ||||||||
| FirstName: | MARK | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1090 AMSTERDAM AVENUE SUITE 16A | ||||||||
| Address2: | MOUNT SINAI ST. LUKE'S | ||||||||
| City: | NEW YORK CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10025 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 1090 AMSTERDAM AVENUE SUITE 16A | ||||||||
| Address2: | MOUNT SINAI ST. LUKE'S | ||||||||
| City: | NEW YORK CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125235089 | ||||||||
| FaxNumber: | 2125231685 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2015 | ||||||||
| LastUpdateDate: | 02/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 288911 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.