Mini George Abraham, MD
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Allentown, PA
NPI 1295726313 · NPPES record last updated Oct 11, 2016
Key facts
- NPI
- 1295726313
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- MD420895 (PA)
- Practice address
- 794 Roble Rd
Allentown, PA 18109-9110 - Phone
- (877) 402-4221
- Fax
- (484) 425-8159
- NPI assigned
- Oct 31, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200803000956 | PA | Order and Referring Only - Pathology |
7012986409 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr George Abraham PC | Past | Accepting new patients | |
| Health Network Laboratories, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MD420895 | PA | Yes |
Addresses
Primary practice location
794 Roble Rd
Allentown, PA 18109-9110
Mailing address
460 N Apple Tree LN
Lafayette Hill, PA 19444-2602
Phone (610) 825-9527
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30021250 | Other | PA | KMHP |
| 1641370 | Other | PA | BLUE SHIELD |
| 2315870000 | Other | PA | KEYSTONE HEALTH PLAN EAST |
| 1011606100001 | Medicaid | PA |
Other providers in Allentown, PA
- Hanadi Abou Dargham
- Sandra Abouafech
- Karen Youse Aboyoun
- Christine M Abraham
- Imad Abraham
- Zach Mathew Abraham
- Susan Elizabeth Abrams
- Sally Abruzzese
- Saif Abu-Baker
- Esther Acevedo Rosa
All providers in Allentown, PA · Anatomic Pathology & Clinical Pathology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.