Provider Demographics
NPI:1851678270
Name:ASE MEDICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ASE MEDICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:AH
Authorized Official - Last Name:MOOSAVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-761-5083
Mailing Address - Street 1:13201 W WARREN AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-5029
Mailing Address - Country:US
Mailing Address - Phone:313-945-0800
Mailing Address - Fax:313-922-5011
Practice Address - Street 1:13201 W WARREN AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-5029
Practice Address - Country:US
Practice Address - Phone:313-945-0800
Practice Address - Fax:313-922-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty