Healthcare Provider Details

I. General information

NPI: 1043217367
Provider Name (Legal Business Name): CHRISTOPHER CHARLES ASHLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 04/17/2020
Certification Date: 04/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HOLLAND AVE
ALBANY NY
12208-3410
US

IV. Provider business mailing address

20 LOUDON PKWY
ALBANY NY
12211-1644
US

V. Phone/Fax

Practice location:
  • Phone: 518-626-5000
  • Fax: 518-626-6606
Mailing address:
  • Phone: 518-248-2173
  • Fax: 518-626-6606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number205186
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: