1356395610 NPI number — DR. IRA H. ASHER MD

Table of content: DR. KAYVON ALI DOWLATSHAHI (NPI 1891176954)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356395610 NPI number — DR. IRA H. ASHER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASHER
Provider First Name:
IRA
Provider Middle Name:
H.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356395610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 EAST MANNING ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-272-2020
Provider Business Mailing Address Fax Number:
401-421-5979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
55 VILLAGE SQUARE DRIVE
Provider Second Line Business Practice Location Address:
BUILDING 24
Provider Business Practice Location Address City Name:
SOUTH KINGSTOWN
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-272-2020
Provider Business Practice Location Address Fax Number:
401-789-4113
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  MD05145 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: IA00222 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 324 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 000169 . This is a "BLUE CHIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 180012015 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0800100 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1103 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: R001038 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 050369447 . This is a "VISION SERVICE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 055040 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4565335 . This is a "AETNA NON HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6941370001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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