Provider Demographics
NPI:1235520271
Name:ALLIED MEDICAL AND DIAGNOSTIC SERVICES, DISPENSARY
Entity Type:Organization
Organization Name:ALLIED MEDICAL AND DIAGNOSTIC SERVICES, DISPENSARY
Other - Org Name:ALLIED MEDICAL AND DIAGNOSTIC SERVICES, DISPENSARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-576-8705
Mailing Address - Street 1:1410 BROADWAY, 23RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:212-575-2898
Mailing Address - Fax:
Practice Address - Street 1:1410 BROADWAY, 23RD FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:212-575-2898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site