MEDICARE: ASHLEY E PATRICK MA, M.ED, MSED

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1851011134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY E PATRICK MA, M.ED, MSED

Provider Business Mailing Address
First Line	:	25021 NORTHERN BLVD LOWR LEVEL
Second Line	:
City	:	LITTLE NECK
State	:	NY
Zip	:	11362-1353
Country	:	US
Telephone Number	:	631-827-9189
Fax Number	:

Provider Business Practice Location Address
First Line	:	25021 NORTHERN BLVD LOWR LEVEL
Second Line	:
City	:	LITTLE NECK
State	:	NY
Zip	:	11362-1353
Country	:	US
Telephone Number	:	631-827-9189
Fax Number	:

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

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	08/29/2022

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