Provider Demographics
NPI:1114919123
Name:PROCTOR, ASHA (MD)
Entity Type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PRINCESS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2302
Mailing Address - Country:US
Mailing Address - Phone:609-896-0777
Mailing Address - Fax:609-896-3266
Practice Address - Street 1:2 PRINCESS RD
Practice Address - Street 2:SUITE C
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2302
Practice Address - Country:US
Practice Address - Phone:609-896-0777
Practice Address - Fax:609-896-3266
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07941300207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology