MEDICARE: MRS. PATRICIA L ASHBOCK LPN

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	164W00000X	Licensed Practical Nurse	26NP04564000	NJ

General Provider Information

NPI Number	:	1659303402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA L ASHBOCK LPN

Provider Business Mailing Address
First Line	:	12 VAN SAUN DRIVE
Second Line	:
City	:	WEST TRENTON
State	:	NJ
Zip	:	08628-1534
Country	:	US
Telephone Number	:	609-883-1734
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 BUNN DR.
Second Line	:	STE 101
City	:	PRINCETON
State	:	NJ
Zip	:	08540-1968
Country	:	US
Telephone Number	:	609-921-2800
Fax Number	:	609-921-3499

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	04/22/2010

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