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NPI Code Detail

MEDICARE: ASHLEY ELIZABETH BATHKE PA-C

MEDICARE: ASHLEY ELIZABETH BATHKE PA-C
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
1363A00000XPhysician AssistantPA9109604FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA9109604OTHERFLPA LICENSE

General Provider Information

NPI Number : 1972954212
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY ELIZABETH BATHKE PA-C
Provider Business Mailing Address
First Line : 1728 SUNRISE HWY
Second Line :
City : MERRICK
State : NY
Zip : 11566-3745
Country : US
Telephone Number : 516-536-2800
Fax Number : 516-536-6820
Provider Business Practice Location Address
First Line : 1728 SUNRISE HWY
Second Line :
City : MERRICK
State : NY
Zip : 11566-3745
Country : US
Telephone Number : 516-536-2800
Fax Number : 516-536-6820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2016
Last Update Date : 07/29/2021

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