Provider Demographics
NPI:1417924267
Name:ALLEY, ALBERT J (DO)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:J
Last Name:ALLEY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:301 WEST THIRD STREET
Mailing Address - Street 2:ALBERT J ALLEY DO
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603
Mailing Address - Country:US
Mailing Address - Phone:570-759-0351
Mailing Address - Fax:570-759-1992
Practice Address - Street 1:301 WEST THIRD STREET
Practice Address - Street 2:ALBERT J ALLEY DO
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603
Practice Address - Country:US
Practice Address - Phone:570-759-0351
Practice Address - Fax:570-759-1992
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2010-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS006707L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001200703Medicaid
599901Medicare ID - Type Unspecified
PA001200703Medicaid