Provider Demographics
NPI:1902327810
Name:PARACHA, ABIGAIL ELAINE
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:ELAINE
Last Name:PARACHA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:ELAINE
Other - Last Name:MARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:67-12 JUNO STREET FL 2
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:917-923-0634
Mailing Address - Fax:
Practice Address - Street 1:10011 67TH RD APT 501
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2721
Practice Address - Country:US
Practice Address - Phone:917-923-0634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05338472Medicaid