Provider Demographics
NPI:1124038245
Name:ASHTON, RICHARD LAWRENCE (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LAWRENCE
Last Name:ASHTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-6301
Mailing Address - Country:US
Mailing Address - Phone:516-455-5843
Mailing Address - Fax:718-767-4787
Practice Address - Street 1:5 CLEARWATER DR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-6301
Practice Address - Country:US
Practice Address - Phone:516-455-5843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235723207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I47527Medicare UPIN
NY3326P1Medicare ID - Type Unspecified