Provider Demographics
NPI:1275164287
Name:ARROYO, ASHLEY N (PA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:ARROYO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 N COUNTRY RD STE 10
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-1761
Mailing Address - Country:US
Mailing Address - Phone:631-250-9582
Mailing Address - Fax:
Practice Address - Street 1:412 N COUNTRY RD STE 10
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1761
Practice Address - Country:US
Practice Address - Phone:631-250-9582
Practice Address - Fax:631-250-9615
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024370363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant