Basic Information
| Provider Information | |||||||||
| NPI: | 1578847695 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CURTIS | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | KING | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 EAST MAIN STREET | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | SMITHTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312651622 | ||||||||
| FaxNumber: | 6312653042 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 E MAIN ST | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | SMITHTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117872871 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312651622 | ||||||||
| FaxNumber: | 6312653042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2011 | ||||||||
| LastUpdateDate: | 09/22/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | 26NJ00348400 | NJ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LP0808X | F401468-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.