Provider Demographics
NPI:1962384115
Name:AMBROSE, STEVEN ALLEN JR
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ALLEN
Last Name:AMBROSE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 FLIGHT O ARROWS WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-1614
Mailing Address - Country:US
Mailing Address - Phone:240-591-8904
Mailing Address - Fax:
Practice Address - Street 1:518 FLIGHT O ARROWS WAY
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-1614
Practice Address - Country:US
Practice Address - Phone:240-591-8904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant