Provider Demographics
NPI:1497147979
Name:ASHMORE, PATRICIA NOEL (PA-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:NOEL
Last Name:ASHMORE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 ADELPHI ST APT 12
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3338
Mailing Address - Country:US
Mailing Address - Phone:973-417-8754
Mailing Address - Fax:
Practice Address - Street 1:5 COLOMBUS CIRCLE
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:973-417-8754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018461363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant