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General NPI Number Information
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NPI Number | 1780258830
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Entity Type | Organization
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Legal Business Name | AA&S HEALTH
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 650 S KIBBY ST
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City | CLINTON
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State | IN
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Zip | 47842
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Country | US
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Telephone | 812-201-6299
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Fax |
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Provider Business Mailing Address
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Address Line | 2093 PHILADELPHIA PIKE #1350
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City | CLAYMONT
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State | DE
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Zip | 19703
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Country | US
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Telephone | 812-201-6299
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ASSAD MUKHTOY
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Credential | MD
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Telephone | 314-601-4078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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