Provider Demographics
NPI:1780270611
Name:WHITSON, ASHLEY E (DPT)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:E
Last Name:WHITSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 W 55TH ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5377
Mailing Address - Country:US
Mailing Address - Phone:631-896-9194
Mailing Address - Fax:
Practice Address - Street 1:369 LEXINGTON AVE RM 18B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6551
Practice Address - Country:US
Practice Address - Phone:212-706-9082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046793-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist