Provider Demographics
NPI:1477015253
Name:ASHFORTH, GINA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIA
Last Name:ASHFORTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GINA
Other - Middle Name:MARIA
Other - Last Name:FRANCISCO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3405 STATE ROUTE 33
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3442
Mailing Address - Country:US
Mailing Address - Phone:732-776-4483
Mailing Address - Fax:
Practice Address - Street 1:3405 STATE ROUTE 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3442
Practice Address - Country:US
Practice Address - Phone:732-776-4483
Practice Address - Fax:732-776-4798
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11700000207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology