Provider Demographics
NPI:1003146903
Name:ASHELD, DANA MARIE (PA)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:ASHELD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:MARIE
Other - Last Name:BIGNAMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:69 LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-3023
Mailing Address - Country:US
Mailing Address - Phone:631-671-5809
Mailing Address - Fax:
Practice Address - Street 1:8616 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2042
Practice Address - Country:US
Practice Address - Phone:718-805-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013715-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical