Provider Demographics
NPI:1811764327
Name:ALLEN, ALANNAH
Entity type:Individual
Prefix:
First Name:ALANNAH
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5600
Mailing Address - Country:US
Mailing Address - Phone:718-909-0785
Mailing Address - Fax:
Practice Address - Street 1:501 CHESTNUT RIDGE RD STE 205
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-5669
Practice Address - Country:US
Practice Address - Phone:718-909-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist