Provider Demographics
NPI:1386051092
Name:IGNATIUK, ASHLEY (MSC, MD, FRCSC)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:IGNATIUK
Suffix:
Gender:M
Credentials:MSC, MD, FRCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BERGEN ST RM 1205
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-3000
Mailing Address - Country:US
Mailing Address - Phone:973-972-8092
Mailing Address - Fax:973-972-8567
Practice Address - Street 1:90 BERGEN ST FL STREET7
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2425
Practice Address - Country:US
Practice Address - Phone:973-972-8092
Practice Address - Fax:973-972-8567
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00557102082S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand