Provider Demographics
NPI:1376636266
Name:ALLEY & ALLEY INTERNAL MEDICINE PA
Entity Type:Organization
Organization Name:ALLEY & ALLEY INTERNAL MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIURKA
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:ALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:561-447-7737
Mailing Address - Street 1:660 GLADES RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431
Mailing Address - Country:US
Mailing Address - Phone:561-447-7737
Mailing Address - Fax:561-447-9022
Practice Address - Street 1:660 GLADES RD
Practice Address - Street 2:SUITE 140
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-447-7737
Practice Address - Fax:561-447-9022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1628Medicare ID - Type Unspecified