Basic Information
| Provider Information | |||||||||
| NPI: | 1467980086 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHSAN | ||||||||
| FirstName: | AYESHA | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2330 ROUTE 33 | ||||||||
| Address2: | STE 107 | ||||||||
| City: | ROBBINSVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086911431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6093034000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 HIGHLANDS DR | ||||||||
| Address2: | |||||||||
| City: | LITITZ | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175437694 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176255000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2017 | ||||||||
| LastUpdateDate: | 08/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MB10891200 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | OS019668 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.