Healthcare Provider Details

I. General information

NPI: 1437028156
Provider Name (Legal Business Name): MONIFA ASH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 PINELAWN AVE
SHIRLEY NY
11967-1919
US

IV. Provider business mailing address

94 PINELAWN AVE
SHIRLEY NY
11967-1919
US

V. Phone/Fax

Practice location:
  • Phone: 631-294-6162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number568533-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: