Healthcare Provider Details

I. General information

NPI: 1013798180
Provider Name (Legal Business Name): MS. ASHLEY LYNN JABLONOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2023
Last Update Date: 10/13/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HEMPSTEAD TURNPIKE
HEMPSTEAD NY
11549-0001
US

IV. Provider business mailing address

31 WHEELWRIGHT LN
LEVITTOWN NY
11756-5232
US

V. Phone/Fax

Practice location:
  • Phone: 516-463-6600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: