Provider Demographics
NPI:1861447260
Name:UNWALA, ASHFAQUE A (MD)
Entity Type:Individual
Prefix:
First Name:ASHFAQUE
Middle Name:A
Last Name:UNWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 W RED BANK AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-1630
Mailing Address - Country:US
Mailing Address - Phone:856-845-6807
Mailing Address - Fax:856-845-3760
Practice Address - Street 1:17 W RED BANK AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1630
Practice Address - Country:US
Practice Address - Phone:856-845-6807
Practice Address - Fax:856-845-3760
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA49960207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA433316OtherAMERIHEALTH ADMINISTRATOR
PA605126POCOtherPENNSYLVANIA MEDICARE
NJ222173875OtherBLUE SHIELD
PA0100180000OtherPENNSYLVANIA BLUE SHIELD
NJ1092191OtherHORIZON MERCY
NJ1222601Medicaid
NJ57554OtherAETNA HMO
NJF04774OtherHEALTHNET
NJ0100180000OtherAMERIHEALTH
NJ0853447OtherCIGNA
NJP441496OtherOXFORD
NJF04774OtherHEALTHNET
PA605126POCOtherPENNSYLVANIA MEDICARE