Provider Demographics
NPI:1366802951
Name:BRISSETTE, ASHLEY R (MD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:R
Last Name:BRISSETTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E 60TH ST RM 602
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1811
Mailing Address - Country:US
Mailing Address - Phone:212-808-4888
Mailing Address - Fax:212-808-4999
Practice Address - Street 1:110 E 60TH ST RM 602
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1811
Practice Address - Country:US
Practice Address - Phone:212-808-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282728-01207W00000X
NY282728207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist