Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 188527 | NY |
NPI | 1396774998 |
---|---|
Provider Name | Jeffrey Richard Allen |
First Address | Rochester, NY 14626-4122 |
Second Address | Rochester, NY 14626-4122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 19/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01403543 | (05) | NY |