Basic Information
Provider Information
NPI: 1508828526
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASHURST-FRIEDMAN
FirstName: ALLISON
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ASHURST
OtherFirstName: ALLISON
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: DPT
OtherLastNameType: 2
Mailing Information
Address1: 210 NORTH AVE E
Address2:  
City: CRANFORD
State: NJ
PostalCode: 070162441
CountryCode: US
TelephoneNumber: 9082760237
FaxNumber: 9082765692
Practice Location
Address1: 210 NORTH AVE E
Address2:  
City: CRANFORD
State: NJ
PostalCode: 070162441
CountryCode: US
TelephoneNumber: 9082760237
FaxNumber: 9082765692
Other Information
ProviderEnumerationDate: 04/05/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA00849400NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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