Provider Demographics
NPI:1780258830
Name:AA&S HEALTH
Entity type:Organization
Organization Name:AA&S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ASSAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MUKHTOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-601-4078
Mailing Address - Street 1:2093 PHILADELPHIA PIKE #1350
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703
Mailing Address - Country:US
Mailing Address - Phone:812-201-6299
Mailing Address - Fax:
Practice Address - Street 1:650 S KIBBY ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IN
Practice Address - Zip Code:47842
Practice Address - Country:US
Practice Address - Phone:812-201-6299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty