Provider Demographics
NPI:1285298489
Name:GRAHAM, ASHLEIGH
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 HARVEST WOODS RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFALL
Mailing Address - State:CT
Mailing Address - Zip Code:06481-2051
Mailing Address - Country:US
Mailing Address - Phone:954-512-3057
Mailing Address - Fax:
Practice Address - Street 1:PATHOLOGY BUILDING, RM 401
Practice Address - Street 2:600 N. WOLFE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:954-512-3057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2019-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program