Provider Demographics
NPI:1760100275
Name:REID, ASHLIE
Entity Type:Individual
Prefix:
First Name:ASHLIE
Middle Name:
Last Name:REID
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 1:1125 WYATT ST APT 5D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-4500
Mailing Address - Country:US
Mailing Address - Phone:929-330-9687
Mailing Address - Fax:
Practice Address - Street 1:1125 WYATT ST APT 5D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4500
Practice Address - Country:US
Practice Address - Phone:929-330-9687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program