Provider Demographics
NPI:1578554952
Name:INGLIS, ALLAN EVANS JR (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:EVANS
Last Name:INGLIS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 E 72ND ST FL 7
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4099
Mailing Address - Country:US
Mailing Address - Phone:212-265-5566
Mailing Address - Fax:212-265-4615
Practice Address - Street 1:523 E 72ND ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4099
Practice Address - Country:US
Practice Address - Phone:212-265-5566
Practice Address - Fax:212-265-4615
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174327207XS0114X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01221865Medicaid
NY01221865Medicaid
NY55F901Medicare PIN