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Individual

ASHLEY BLAKE STRONGWATER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
215 NORTH AVE W, WESTFIELD, NJ 07090-1491
(908) 308-4500
(217) 286-6107
Mailing address
176 S 4TH ST APT 6A, BROOKLYN, NY 11211-5372
(914) 760-8014
(217) 286-6107

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
016928
NY
363A00000X
Physician Assistant
25MP0061990
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016928
NY STATE LICENSE
NY
01
25MP0061990
NJ STATE LICENSE
NJ
Enumeration date
10/29/2013
Last updated
09/10/2021
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