Provider Demographics
NPI:1124864996
Name:ROBERTS, ASHLEY SUZETTE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SUZETTE
Last Name:ROBERTS
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 1:10833 160TH ST # 28B
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-2854
Mailing Address - Country:US
Mailing Address - Phone:929-268-7680
Mailing Address - Fax:
Practice Address - Street 1:10833 160TH ST # 28B
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11433-2854
Practice Address - Country:US
Practice Address - Phone:929-268-7680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula