=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235055765
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHYRA PITTMAN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/29/2026
-----------------------------------------------------
Last Update Date | 06/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 220 TILGHMAN RD
-----------------------------------------------------
City | SALISBURY
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21804-1921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-546-4600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12134 QUEENS GRANT DR
-----------------------------------------------------
City | PRINCESS ANNE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21853-3016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | 5563
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------