Provider Demographics
NPI:1508426388
Name:SANON, ASHLEY JOELLE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JOELLE
Last Name:SANON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22004 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11411-1621
Mailing Address - Country:US
Mailing Address - Phone:305-467-9786
Mailing Address - Fax:
Practice Address - Street 1:17323 VASWANI AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3305
Practice Address - Country:US
Practice Address - Phone:305-467-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator