Provider Demographics
NPI:1649622390
Name:O'CONNOR, ASHLEY (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 MYSTIC LN
Mailing Address - Street 2:
Mailing Address - City:WEST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3614
Mailing Address - Country:US
Mailing Address - Phone:610-551-9140
Mailing Address - Fax:
Practice Address - Street 1:90 S NEWTOWN STREET RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4041
Practice Address - Country:US
Practice Address - Phone:610-551-9140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055955363AM0700X
PAOA003000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical