Provider Demographics
NPI:1033414719
Name:RONCONE, ASHLEY MARY (PA-C, MS)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARY
Last Name:RONCONE
Suffix:
Gender:F
Credentials:PA-C, MS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARY
Other - Last Name:WHITTAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, MS
Mailing Address - Street 1:4 EVES DR # A
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3195
Mailing Address - Country:US
Mailing Address - Phone:609-267-9400
Mailing Address - Fax:609-267-9457
Practice Address - Street 1:4 EVES DR # A
Practice Address - Street 2:SUITE 100
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3195
Practice Address - Country:US
Practice Address - Phone:609-267-9400
Practice Address - Fax:609-267-9457
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00255000363A00000X
PA25MP00255000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant