Provider Demographics
NPI:1417780115
Name:ASHLEY BRISSETTE LLC
Entity type:Organization
Organization Name:ASHLEY BRISSETTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISSETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-808-4888
Mailing Address - Street 1:110 E 60TH ST STE 602
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1694
Mailing Address - Country:US
Mailing Address - Phone:212-808-4888
Mailing Address - Fax:212-808-4999
Practice Address - Street 1:110 E 60TH ST STE 602
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1694
Practice Address - Country:US
Practice Address - Phone:212-808-4888
Practice Address - Fax:212-808-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty