Provider Demographics
NPI:1568088615
Name:ASHRAF, AQSA (MD)
Entity Type:Individual
Prefix:MS
First Name:AQSA
Middle Name:
Last Name:ASHRAF
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 1:75 N COUNTRY ROAD MATHER HOSPITAL INTERNAL MEDICINE RES
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777
Mailing Address - Country:US
Mailing Address - Phone:631-686-2517
Mailing Address - Fax:631-686-7651
Practice Address - Street 1:75 N COUNTRY ROAD MATHER HOSPITAL INTERNAL MEDICINE RES
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777
Practice Address - Country:US
Practice Address - Phone:631-473-1328
Practice Address - Fax:631-686-7651
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2023-05-24
Deactivation Date:2022-01-17
Deactivation Code:
Reactivation Date:2023-05-24
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program