Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 25MA06833500 | NJ |
NPI | 1346376845 |
---|---|
Provider Name | Dr. Robert A Allen |
First Address | Haddon Heights, NJ 08035-1908 |
Second Address | Mount Laurel, NJ 08054-1129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H34146 | (02) | NJ |