Provider Demographics
NPI:1285815407
Name:EINHORN, ALLAN JACK (MS)
Entity type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:JACK
Last Name:EINHORN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:MR
Other - First Name:ELIEZER
Other - Middle Name:YITZCHOK
Other - Last Name:EINHORN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:285 CENTRAL AVE
Mailing Address - Street 2:E-4
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559
Mailing Address - Country:US
Mailing Address - Phone:516-581-2771
Mailing Address - Fax:
Practice Address - Street 1:285 CENTRAL AVE
Practice Address - Street 2:E-4
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559
Practice Address - Country:US
Practice Address - Phone:516-581-2771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY850231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01013794Medicaid