Individual provider Active NPI

Tracee Rae Abrams, PHARMD

  • Pharmacist
  • Liberty, NY
National Provider Identifier
1790969863
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
049681 Issued in NY
Practice address
267 N Main St
Liberty, NY 12754-1850
Phone
(845) 295-5456
Fax
(845) 295-5458
NPI assigned
Dec 24, 2007
Last updated
Aug 5, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 049681 NY Primary

Addresses

Primary practice location

267 N Main St
Liberty, NY 12754-1850

Mailing address

267 N Main St
Liberty, NY 12754-1850
Phone (845) 295-5456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
049681NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sullivan Pharmacy Inc PastSince Feb 8, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249430400000",
    "number": "1790969863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 N MAIN ST",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127541850",
            "telephone_number": "845-295-5456",
            "fax_number": "845-295-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 N MAIN ST",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127541850",
            "telephone_number": "845-295-5456",
            "fax_number": "845-295-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAMS",
        "first_name": "TRACEE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2009-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "049681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.