Basic Information
| Provider Information | |||||||||
| NPI: | 1508090267 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BYROM | ||||||||
| FirstName: | ABBIE | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 254 EASTON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327458600 | ||||||||
| FaxNumber: | 7327452642 | ||||||||
| Practice Location | |||||||||
| Address1: | 254 EASTON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327458600 | ||||||||
| FaxNumber: | 7327452642 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2009 | ||||||||
| LastUpdateDate: | 09/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 53447 | TN | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 25MA09079600 | NJ | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.