Basic Information
Provider Information
NPI: 1659756765
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EWASKO
FirstName: ASHLEY
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: CERTIIFIED REGISTERE
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WEBER
OtherFirstName: ASHLEY
OtherMiddleName: E
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 2 READS WAY
Address2: SUITE #201
City: NEW CASTLE
State: DE
PostalCode: 197201630
CountryCode: US
TelephoneNumber: 3027094709
FaxNumber: 3027094551
Practice Location
Address1: 4755 OGLETOWN STANTON RD
Address2:  
City: NEWARK
State: DE
PostalCode: 197180002
CountryCode: US
TelephoneNumber: 3027331000
FaxNumber: 3027332685
Other Information
ProviderEnumerationDate: 07/30/2015
LastUpdateDate: 01/04/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XL6-0A00733DEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home