Healthcare Provider Details

I. General information

NPI: 1538076039
Provider Name (Legal Business Name): ASHRAF MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3144 E MAIN ST
MOHEGAN LAKE NY
10547-1517
US

IV. Provider business mailing address

900 ROUTE 376 STE H
WAPPINGERS FALLS NY
12590-6496
US

V. Phone/Fax

Practice location:
  • Phone: 845-204-9260
  • Fax:
Mailing address:
  • Phone: 845-204-9260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATELIN ANNE BUICE
Title or Position: BILLING ADMIN/ CREDENTIALING
Credential:
Phone: 845-204-9260