Basic Information
| Provider Information | |||||||||
| NPI: | 1932164076 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABRAMSON | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | LAWRENCE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 905 | ||||||||
| Address2: | |||||||||
| City: | FALMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085488989 | ||||||||
| FaxNumber: | 5085485789 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 SERVICE RD | ||||||||
| Address2: | |||||||||
| City: | E SANDWICH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02537 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088334000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 03/03/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 151111 | MA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 151111 | 01 | TUFTS HEALTH | OTHER | 80547 | 01 | HARVARD PILGRIM | OTHER | J18567 | 01 | BLUE CROSS | OTHER | 3177017 | 05 | MA | MEDICAID |