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General NPI Number Information
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NPI Number | 1457722803
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Entity Type | Organization
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Legal Business Name | ASHRAF MEDICAL MD.PA
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 475 WATCHUNG AVE SUITE 8
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City | WATCHUNG
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State | NJ
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Zip | 07069
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Country | US
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Telephone | 732-439-8223
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Fax |
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Provider Business Mailing Address
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Address Line | 475 WATCHUNG AVE STE 8
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City | WATCHUNG
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State | NJ
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Zip | 07069-4951
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Country | US
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Telephone | 732-439-8223
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | BAHMAN ASHRAF
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Credential | MD
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Telephone | 732-439-8223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 25MA04648400
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License Number State | NJ
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