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General NPI Number Information
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NPI Number | 1821426800
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Entity Type | Individual
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Provider Name | ASHLEY BLAKE STRONGWATER PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 215 NORTH AVE W
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City | WESTFIELD
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State | NJ
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Zip | 07090-1491
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Country | US
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Telephone | 908-308-4500
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Fax | 217-286-6107
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Provider Business Mailing Address
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Address Line | 176 S 4TH ST APT 6A
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City | BROOKLYN
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State | NY
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Zip | 11211-5372
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Country | US
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Telephone | 914-760-8014
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Fax | 217-286-6107
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP0061990
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 016928
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License Number State | NY
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