Ashley Abraham
Individual provider Active NPI Dentist · Hackensack, NJ
NPI 1740975135 · NPPES record last updated Oct 22, 2024
Key facts
- NPI
- 1740975135
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 064360-01 (NY)
- Practice address
- 30 Prospect Ave
Hackensack, NJ 07601-1915 - Phone
- (551) 996-5365
- NPI assigned
- Apr 10, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064360-01 | NY | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 064360-01 | NY | Yes |
Addresses
Primary practice location
30 Prospect Ave
Hackensack, NJ 07601-1915
Mailing address
462 S Broadway
Yonkers, NY 10705-2340
Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.