Healthcare Provider Details

I. General information

NPI: 1366802951
Provider Name (Legal Business Name): ASHLEY R BRISSETTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2016
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E 60TH ST RM 602
NEW YORK NY
10022-1811
US

IV. Provider business mailing address

110 E 60TH ST RM 602
NEW YORK NY
10022-1811
US

V. Phone/Fax

Practice location:
  • Phone: 212-808-4888
  • Fax:
Mailing address:
  • Phone: 212-808-4888
  • Fax: 212-808-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number282728-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number282728
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: