Basic Information
Provider Information
NPI: 1790196418
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABRAMS
FirstName: SARAH
MiddleName: ALEXANDRA
NamePrefix: MRS.
NameSuffix:  
Credential: COTA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5741 S 800 W
Address2:  
City: MANILLA
State: IN
PostalCode: 461509725
CountryCode: US
TelephoneNumber: 3177530128
FaxNumber:  
Practice Location
Address1: 303 N HURSTBOURNE PKWY STE 200
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402225158
CountryCode: US
TelephoneNumber: 5024125847
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/15/2014
LastUpdateDate: 05/15/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000X32002649AINY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


Home