Provider Demographics
NPI:1144542408
Name:SEBRANSKY, ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:SEBRANSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39755 N 106TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-3346
Mailing Address - Country:US
Mailing Address - Phone:480-595-0717
Mailing Address - Fax:480-393-3667
Practice Address - Street 1:39755 N 106TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85262-3346
Practice Address - Country:US
Practice Address - Phone:480-595-0717
Practice Address - Fax:480-393-3667
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29904208600000X
CAC28395208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery