Provider Demographics
NPI:1467899617
Name:BASSETT, ASHLEY J (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:BASSETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 LAFAYETTE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-3560
Mailing Address - Country:US
Mailing Address - Phone:908-684-3005
Mailing Address - Fax:908-684-3301
Practice Address - Street 1:376 LAFAYETTE RD STE 202
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-3560
Practice Address - Country:US
Practice Address - Phone:908-684-3005
Practice Address - Fax:908-684-3301
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-255186207X00000X
PAMT216830207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery