Provider Demographics
NPI:1801883061
Name:ALLATT, RICHARD D (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:ALLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-0251
Mailing Address - Country:US
Mailing Address - Phone:814-235-3051
Mailing Address - Fax:814-359-5629
Practice Address - Street 1:550 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:PLEASANT GAP
Practice Address - State:PA
Practice Address - Zip Code:16823-7401
Practice Address - Country:US
Practice Address - Phone:814-359-5620
Practice Address - Fax:814-359-5629
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049145-L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA250006141OtherRAILROAD MEDICARE#
PA01016501OtherCAPITAL BCBS#
PA0014022620001Medicaid
PA486108OtherHIGHMARK BCBS#
PA097686OtherMEDICARE LEGACY GROUP #
PA486108OtherHIGHMARK BCBS#
PA0014022620001Medicaid