Provider Demographics
NPI:1104459775
Name:MARSHALL, ALLAN
Entity type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-3010
Mailing Address - Country:US
Mailing Address - Phone:347-848-2511
Mailing Address - Fax:347-758-7715
Practice Address - Street 1:338 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-3010
Practice Address - Country:US
Practice Address - Phone:347-848-2511
Practice Address - Fax:347-758-7715
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)