Provider Demographics
NPI:1295823474
Name:ASHMEAD, GRAHAM G (MD)
Entity Type:Individual
Prefix:
First Name:GRAHAM
Middle Name:G
Last Name:ASHMEAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 95000-4930
Mailing Address - Street 2:PERINATAL ASSOCIATES OF SLR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-4930
Mailing Address - Country:US
Mailing Address - Phone:516-338-5300
Mailing Address - Fax:516-338-1075
Practice Address - Street 1:1000 10TH AVE
Practice Address - Street 2:FETAL EVALUATION UNIT/PERINATAL ASSOCIATES OF SLR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1147
Practice Address - Country:US
Practice Address - Phone:212-523-8110
Practice Address - Fax:212-523-3472
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY241150207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02799360Medicaid
B85519Medicare UPIN
NY02799360Medicaid