Provider Demographics
NPI:1578605598
Name:ALLEN, BARBARA L (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 STRAWBERRY HILL AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2757
Mailing Address - Country:US
Mailing Address - Phone:203-323-7900
Mailing Address - Fax:
Practice Address - Street 1:71 STRAWBERRY HILL AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2757
Practice Address - Country:US
Practice Address - Phone:203-323-7900
Practice Address - Fax:203-323-6633
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030970208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001309708Medicaid