Provider Demographics
NPI:1609052380
Name:TIRMIZI, ASHFAQ H (RPT)
Entity type:Individual
Prefix:MR
First Name:ASHFAQ
Middle Name:H
Last Name:TIRMIZI
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 TOURNAMENT DR UNIT 9
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-8764
Mailing Address - Country:US
Mailing Address - Phone:631-355-6162
Mailing Address - Fax:
Practice Address - Street 1:1711 BROOKHAVEN AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4406
Practice Address - Country:US
Practice Address - Phone:631-355-6162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-13
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006787-1225200000X
NY049935225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant