Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25MA56953000 | NJ |
N | 208000000X | Pediatrician | MD035394E | PA |
N | 2080P0214X | Pediatric Pulmonologist | 25MA56953000 | NJ |
Y | 2080P0214X | Pediatric Pulmonologist | MD035394E | PA |
NPI | 1104844570 |
---|---|
Provider Name | Julian L Allen |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 17/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001044574 | (05) | PA |
2272202 | (05) | NJ |
D71339 | (02) |