Individual
ASHLEY CUNNINGHAM BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
315 S MANNING BLVD, GROUND FLOOR, ROOM 0680, ALBANY, NY 12208-1707
(570) 412-2940
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054468
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
197894
MEDICARE- PTAN
PA
01
—
MA054468
MA LICENSE
PA
01
—
P01160467
RAILROAD MEDICARE PTAN
VA
01
—
VV9043A
MEDICARE PTAN
VA
Enumeration date
08/10/2010
Last updated
05/07/2021
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