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NPI Code Detail

MEDICARE: DR. ROMAN I ASHMYAN DO

MEDICARE: DR. ROMAN I ASHMYAN DO
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
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician25MB11616000NJ

General Provider Information

NPI Number : 1770970386
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROMAN I ASHMYAN DO
Provider Business Mailing Address
First Line : 1455 BROAD ST STE 250
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3066
Country : US
Telephone Number : 877-532-7837
Fax Number :
Provider Business Practice Location Address
First Line : 1455 BROAD ST STE 250
Second Line :
City : BLOOMFIELD
State : NJ
Zip : 07003-3066
Country : US
Telephone Number : 877-532-7837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2015
Last Update Date : 01/05/2026

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