Individual
ASHLEY BUBOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
419 W 114TH ST, NEW YORK, NY 10025-1710
(212) 523-4000
Mailing address
419 W 114TH ST, NEW YORK, NY 10025-1710
(212) 523-4000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
034237
NY
Other
Enumeration date
05/02/2025
Last updated
08/05/2025
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