Provider Demographics
NPI:1942452172
Name:RUSTEMLI, ASU (MD)
Entity Type:Individual
Prefix:DR
First Name:ASU
Middle Name:
Last Name:RUSTEMLI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ASU
Other - Middle Name:
Other - Last Name:YILDIRIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:25 MULE RD UNIT B2
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5037
Mailing Address - Country:US
Mailing Address - Phone:732-505-9005
Mailing Address - Fax:732-505-9919
Practice Address - Street 1:25 MULE RD UNIT B2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5037
Practice Address - Country:US
Practice Address - Phone:732-505-9005
Practice Address - Fax:732-505-9919
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263379207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY263379OtherNY STATE LICENSE