Provider Demographics
NPI:1407055825
Name:SIKORSKI, ALLAN GEORGE (PA)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:GEORGE
Last Name:SIKORSKI
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 E 138TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-3004
Mailing Address - Country:US
Mailing Address - Phone:718-292-0100
Mailing Address - Fax:718-866-0183
Practice Address - Street 1:423 E 138TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-3004
Practice Address - Country:US
Practice Address - Phone:718-292-0100
Practice Address - Fax:718-866-0183
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005966363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant