Most Relevant Information
Provider Data
| NPI Number: | 1003589433 |
| Provider Name: | JACOB ANDREW ABRAHAM |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | P105172 |
Most Important Dates
| Enumeration Date: | 07/30/2021 |
| Last Updated: | 07/30/2021 |
Provider Practice Location
387 FRANKLIN ST
BUFFALO
NY
142021507
Practice Location Phone/Fax
| Phone: | 7164620284 |
| Fax: | 7162620481 |
Provider Mailing Location
102 CUMBERLAND AVE
BUFFALO
NY
142201310
Provider Mailing Phone/Fax
| Phone: | 7169310141 |
| Fax: |