Provider Demographics
NPI:1235374141
Name:ALLEN, LINDSAY MCCONNELL (PA)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MCCONNELL
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 E 94TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5604
Mailing Address - Country:US
Mailing Address - Phone:212-423-3000
Mailing Address - Fax:212-423-2961
Practice Address - Street 1:312 E 94TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5604
Practice Address - Country:US
Practice Address - Phone:212-423-3000
Practice Address - Fax:212-423-2961
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012947363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY00695941Medicaid
NYW6L111Medicare PIN
NY331952Medicare PIN
NY331947Medicare PIN
NY331944Medicare UPIN
NY331946Medicare PIN
NY331943Medicare PIN
NY331957Medicare UPIN
NY331954Medicare PIN
NY331945Medicare PIN