Provider Demographics
NPI:1588110811
Name:ASHRAF, HARIS (DO)
Entity type:Individual
Prefix:
First Name:HARIS
Middle Name:
Last Name:ASHRAF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:SLATE HILL
Mailing Address - State:NY
Mailing Address - Zip Code:10973-4331
Mailing Address - Country:US
Mailing Address - Phone:510-396-7917
Mailing Address - Fax:
Practice Address - Street 1:15 SHORE BLVD
Practice Address - Street 2:
Practice Address - City:SLATE HILL
Practice Address - State:NY
Practice Address - Zip Code:10973-4331
Practice Address - Country:US
Practice Address - Phone:510-396-7917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD4630877207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine