MEDICARE: DR. DIANE MARIE ASHTON MD, MPH

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	207V00000X	Obstetrics & Gynecology Physician	172247	NY

General Provider Information

NPI Number	:	1528523560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE MARIE ASHTON MD, MPH

Provider Business Mailing Address
First Line	:	128 SAINT MARKS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-2412
Country	:	US
Telephone Number	:	917-597-2259
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 SAINT MARKS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-2412
Country	:	US
Telephone Number	:	917-597-2259
Fax Number	:

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

Provider Enumeration Date	:	02/04/2019
Last Update Date	:	02/04/2019

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