Provider Demographics
NPI:1861430654
Name:ASH, REUBEN I (MD)
Entity type:Individual
Prefix:DR
First Name:REUBEN
Middle Name:I
Last Name:ASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 E BAY AVE
Mailing Address - Street 2:SUITE 22B
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3447
Mailing Address - Country:US
Mailing Address - Phone:609-978-0242
Mailing Address - Fax:609-978-0241
Practice Address - Street 1:712 E BAY AVE
Practice Address - Street 2:SUITE 22B
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3447
Practice Address - Country:US
Practice Address - Phone:609-978-0242
Practice Address - Fax:609-978-0241
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03526900207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC30713Medicare UPIN