Healthcare Provider Details

I. General information

NPI: 1316523814
Provider Name (Legal Business Name): ASHLEY LUNDY FNP-C, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

594 BROADWAY RM 409
NEW YORK NY
10012-3234
US

IV. Provider business mailing address

410 E 64TH ST APT 34
NEW YORK NY
10065-7887
US

V. Phone/Fax

Practice location:
  • Phone: 212-274-0800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number357913
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: