Kourgialis, Ashley
Kourgialis, Ashley is an individual health care provider with primary practice located at 30 Prospect Ave , Hackensack NJ 07601-1915. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Kourgialis, Ashley can be contacted via phone (551) 996-5430.Contact Information
Primary practice address
30 Prospect Ave
Hackensack NJ 07601-1915
Phone: (551) 996-5430
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X |
Profile Details
| NPI number | 1639665441 |
|---|---|
| LBN Legal business name | Kourgialis, Ashley |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 4th, 2018 |
| Last updated | Jun 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639665441 | NPPES |
| New Jersey | Other | 25MP00614100 | NJ STATE MEDICAL LICENSE |
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