Provider Demographics
NPI:1285013326
Name:TABI, ASHLEY
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:TABI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 CENTRAL PARK AVE STE 426
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2828
Mailing Address - Country:US
Mailing Address - Phone:347-768-7675
Mailing Address - Fax:
Practice Address - Street 1:2146 BARTOW AVE SPC 280E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4629
Practice Address - Country:US
Practice Address - Phone:347-768-7675
Practice Address - Fax:330-884-3234
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine