MEDICARE: AMIE ASHLEY PHYSICAL THERAPIST

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	225100000X	Physical Therapist	23724	NY

General Provider Information

NPI Number	:	1184672420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIE ASHLEY PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	30 WALL ST
Second Line	:	4TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10005-2201
Country	:	US
Telephone Number	:	212-514-6499
Fax Number	:	212-514-6475

Provider Business Practice Location Address
First Line	:	52 VANDERBILT AVE
Second Line	:	SUITE 1413
City	:	NEW YORK
State	:	NY
Zip	:	10017-3808
Country	:	US
Telephone Number	:	212-599-0099
Fax Number	:	212-599-0389

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	05/30/2013

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