MEDICARE: DR. MITCHEL ASHKANAZY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	25MA04065200	NJ
2	207W00000X	Ophthalmology Physician	MD034605E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548255631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHEL ASHKANAZY MD

Provider Business Mailing Address
First Line	:	170 KINNELON RD
Second Line	:	SUITE 27
City	:	KINNELON
State	:	NJ
Zip	:	07405-2347
Country	:	US
Telephone Number	:	973-838-1211
Fax Number	:	973-283-1281

Provider Business Practice Location Address
First Line	:	170 KINNELON RD
Second Line	:	SUITE 27
City	:	KINNELON
State	:	NJ
Zip	:	07405-2347
Country	:	US
Telephone Number	:	973-838-1211
Fax Number	:	973-283-1281

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	03/22/2012

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