Healthcare Provider Details

I. General information

NPI: 1255710760
Provider Name (Legal Business Name): ASHLEY COTE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2015
Last Update Date: 11/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 HOSPITAL DR
YORK ME
03909-1011
US

IV. Provider business mailing address

15 HOSPITAL DR
YORK ME
03909-1011
US

V. Phone/Fax

Practice location:
  • Phone: 207-363-4321
  • Fax: 207-351-2216
Mailing address:
  • Phone: 207-363-4321
  • Fax: 207-351-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1534
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: