Provider Demographics
NPI:1356498455
Name:HAUSKNECHT, ALLAN (MD)
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:
Last Name:HAUSKNECHT
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 1:301 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1904
Mailing Address - Country:US
Mailing Address - Phone:516-374-2992
Mailing Address - Fax:516-295-9364
Practice Address - Street 1:301 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1904
Practice Address - Country:US
Practice Address - Phone:516-374-2992
Practice Address - Fax:516-295-9364
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0948192084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00156381Medicaid
NY00156381Medicaid
NY377621Medicare ID - Type Unspecified