Provider Demographics
NPI:1376030882
Name:ALLMAN, STEPHANIE GABRIELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:GABRIELLE
Last Name:ALLMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HERRICK DR APT 3M
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1406
Mailing Address - Country:US
Mailing Address - Phone:516-547-2778
Mailing Address - Fax:
Practice Address - Street 1:68 E 161ST ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2207
Practice Address - Country:US
Practice Address - Phone:718-571-9319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant