Provider Demographics
NPI:1720004179
Name:ASHLEY & KUZMA THERAPEUTICS, P.C.
Entity Type:Organization
Organization Name:ASHLEY & KUZMA THERAPEUTICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUZMA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:814-456-5151
Mailing Address - Street 1:2111 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4707
Mailing Address - Country:US
Mailing Address - Phone:814-456-5151
Mailing Address - Fax:814-878-2911
Practice Address - Street 1:2111 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-4707
Practice Address - Country:US
Practice Address - Phone:814-456-5151
Practice Address - Fax:814-878-2911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001377634OtherHIGHMARK BC/BS I.D.
PA135973OtherUNISON I.D.
PA0019192670001Medicaid
PA001377634OtherHIGHMARK BC/BS I.D.