Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 127834 | NY |
NPI | 1154397727 |
---|---|
Provider Name | Jeffrey Allen |
First Address | New York, NY 10016-4974 |
Second Address | New York, NY 10016-4974 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 21/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00941093 | (05) | NY |
C07979 | (02) | NY |