Healthcare Provider Details

I. General information

NPI: 1699742288
Provider Name (Legal Business Name): FREDERICK JOSEPH AST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FRED AST

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E 30TH ST STE 1A
NEW YORK NY
10016-7325
US

IV. Provider business mailing address

35 E 30TH ST STE 1A
NEW YORK NY
10016-7325
US

V. Phone/Fax

Practice location:
  • Phone: 212-725-7027
  • Fax: 212-725-0433
Mailing address:
  • Phone: 212-725-7027
  • Fax: 212-725-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number1783111
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number1783111
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number77224
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1783111
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: