Provider Demographics
NPI:1043962640
Name:CONVENA CARE
Entity Type:Organization
Organization Name:CONVENA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:
Authorized Official - Last Name:NASHED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-892-9662
Mailing Address - Street 1:10 SWACKHAMER RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3025
Mailing Address - Country:US
Mailing Address - Phone:908-892-9662
Mailing Address - Fax:
Practice Address - Street 1:92 E MAIN ST STE 405
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2319
Practice Address - Country:US
Practice Address - Phone:908-895-6969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty