Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 000898 | GA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 253018 | NY |
NPI | 1871770255 |
---|---|
Provider Name | Dr. Abigail Kincaid Allen |
First Address | New York, NY 10029 |
Second Address | New York, NY 10029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2008 |
Last Update Date | 26/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000898 | TEMPORARY STATE LICENSE (01) | GA |
A104354 | CA STATE LICENSE (01) | CA |