Healthcare Provider Details

I. General information

NPI: 1063345668
Provider Name (Legal Business Name): ABUBAKAR ASHFAQ RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6902 RIDGE BLVD APT A3
BROOKLYN NY
11209-1240
US

IV. Provider business mailing address

6902 RIDGE BLVD APT A3
BROOKLYN NY
11209-1240
US

V. Phone/Fax

Practice location:
  • Phone: 347-458-8323
  • Fax:
Mailing address:
  • Phone: 347-458-8323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number729938
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: