Healthcare Provider Details

I. General information

NPI: 1073473146
Provider Name (Legal Business Name): BRANDON ASHER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 BETHEL CHURCH RD
JACKSON NJ
08527-1760
US

IV. Provider business mailing address

905 BETHEL CHURCH RD
JACKSON NJ
08527-1760
US

V. Phone/Fax

Practice location:
  • Phone: 732-778-4797
  • Fax:
Mailing address:
  • Phone: 732-778-4797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15460500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: