Provider Demographics
NPI:1568561173
Name:ALLEN, DAVID (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 S NEW YORK RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9761
Mailing Address - Country:US
Mailing Address - Phone:609-748-2660
Mailing Address - Fax:609-748-8892
Practice Address - Street 1:15 WILLIAM ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2705
Practice Address - Country:US
Practice Address - Phone:973-824-3555
Practice Address - Fax:973-824-3999
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00348500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor