Provider Demographics
NPI:1114570215
Name:PRAWER, ASHLEY MICHELLE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MICHELLE
Last Name:PRAWER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MICHELLE
Other - Last Name:DECTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3003 NEW HYDE PARK RD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:516-327-0001
Mailing Address - Fax:516-326-9753
Practice Address - Street 1:3003 NEW HYDE PARK RD
Practice Address - Street 2:SUITE 411
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-327-0001
Practice Address - Fax:516-326-9753
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431566363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care