Provider Demographics
NPI:1235304700
Name:MITCHEL ASHKANAZY
Entity Type:Organization
Organization Name:MITCHEL ASHKANAZY
Other - Org Name:MITCHEL ASHKANAZY MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITCHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHKANAZY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-838-1211
Mailing Address - Street 1:170 KINNELON RD
Mailing Address - Street 2:SUITE 27
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2347
Mailing Address - Country:US
Mailing Address - Phone:973-838-1211
Mailing Address - Fax:973-283-1281
Practice Address - Street 1:170 KINNELON RD
Practice Address - Street 2:SUITE 27
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2347
Practice Address - Country:US
Practice Address - Phone:973-838-1211
Practice Address - Fax:973-283-1281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear SupplierGroup - Single Specialty