Provider Demographics
NPI:1154301257
Name:GABROY, ALLEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:S
Last Name:GABROY
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 1:204 E CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-1730
Mailing Address - Country:US
Mailing Address - Phone:610-521-4833
Mailing Address - Fax:610-521-2651
Practice Address - Street 1:204 E CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-1730
Practice Address - Country:US
Practice Address - Phone:610-521-4833
Practice Address - Fax:610-521-2651
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013691208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006985460001Medicaid
146174Medicare ID - Type Unspecified
PA0006985460001Medicaid