Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD027600L | PA |
NPI | 1033261318 |
---|---|
Provider Name | Dr. Richard Abbas Alley |
First Address | Wilkes Barre, PA 18702-3549 |
Second Address | Wilkes Barre, PA 18702-3549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 01/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C27138 | (02) | |
MA00595398 | (05) | PA |