Healthcare Provider Details
I. General information
NPI: 1902426281
Provider Name (Legal Business Name): ASHLEY ABUDU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/16/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
475 SEAVIEW AVE
STATEN ISLAND NY
10305-3436
US
IV. Provider business mailing address
19 MORFORD PL APT 5G
RED BANK NJ
07701-1062
US
V. Phone/Fax
- Phone: 718-226-8855
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 036180730 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: