Healthcare Provider Details

I. General information

NPI: 1003200965
Provider Name (Legal Business Name): ASHLEY RAE NOBOA MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS ASHLEY RAE MARKEY

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 BAINBRIDGE AVE
BRONX NY
10467-2403
US

IV. Provider business mailing address

3355 BAINBRIDGE AVE
BRONX NY
10467-2801
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-7200
  • Fax: 718-547-2929
Mailing address:
  • Phone: 347-703-8799
  • Fax: 718-547-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP127819
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number340189
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: