Provider Demographics
NPI:1417461344
Name:BLEICH, ASHLEY CHARLES (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CHARLES
Last Name:BLEICH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 PELHAM PKWY N APT 402
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8070
Mailing Address - Country:US
Mailing Address - Phone:718-519-8326
Mailing Address - Fax:718-881-8714
Practice Address - Street 1:665 PELHAM PKWY N APT 402
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-8070
Practice Address - Country:US
Practice Address - Phone:718-519-8326
Practice Address - Fax:718-881-8714
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY731925163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse