Healthcare Provider Details

I. General information

NPI: 1982445672
Provider Name (Legal Business Name): ASHLEY ALPHONSUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ROUTE 35 STE 200
MIDDLETOWN NJ
07748-2609
US

IV. Provider business mailing address

33 E 33RD ST FL 12
NEW YORK NY
10016-5362
US

V. Phone/Fax

Practice location:
  • Phone: 973-571-2121
  • Fax: 732-856-9373
Mailing address:
  • Phone: 844-337-6362
  • Fax: 646-665-3604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: