Provider Demographics
NPI:1497388821
Name:PIPOLI, ASHLEY P (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:P
Last Name:PIPOLI
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 1:137 HIGH ST FL 2A
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1476
Mailing Address - Country:US
Mailing Address - Phone:609-474-0120
Mailing Address - Fax:
Practice Address - Street 1:4000 NEXUS DR STE NE3-100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3000
Practice Address - Country:US
Practice Address - Phone:302-320-9771
Practice Address - Fax:302-623-7964
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00560300363AM0700X
DEC5-0011636363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty