Healthcare Provider Details

I. General information

NPI: 1750484341
Provider Name (Legal Business Name): CAROL E ASH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 BROAD ST SUITE 206
RED BANK NJ
07701-2028
US

IV. Provider business mailing address

157 BROAD ST SUITE 206
RED BANK NJ
07701-2028
US

V. Phone/Fax

Practice location:
  • Phone: 732-530-2960
  • Fax: 732-530-7446
Mailing address:
  • Phone: 732-530-2960
  • Fax: 732-530-7446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberMB56454
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number25MB05645400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: