MEDICARE: DR. JOHN R ASHBURN JR. PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	020349	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124178538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN R ASHBURN JR. PHD

Provider Business Mailing Address
First Line	:	PO BOX 43
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-0043
Country	:	US
Telephone Number	:	845-849-1958
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 ROUTE 52 STE F
Second Line	:
City	:	HOPEWELL JUNCTION
State	:	NY
Zip	:	12533-3218
Country	:	US
Telephone Number	:	845-629-0034
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	09/05/2025

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