Provider Demographics
NPI:1871927491
Name:DAVID, ASHLEY (PHARMD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DAVID
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 ROUTE 304
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1627
Mailing Address - Country:US
Mailing Address - Phone:845-623-6232
Mailing Address - Fax:
Practice Address - Street 1:330 ROUTE 304
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-1627
Practice Address - Country:US
Practice Address - Phone:845-623-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist