Provider Demographics
NPI:1659386324
Name:ALLIS, BARBARA A (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:ALLIS
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 1:120 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2743
Mailing Address - Country:US
Mailing Address - Phone:631-351-3815
Mailing Address - Fax:631-367-5420
Practice Address - Street 1:120 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2743
Practice Address - Country:US
Practice Address - Phone:631-351-3815
Practice Address - Fax:631-367-5420
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158535-12084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY21E611OtherBLUE CROSS/ BLUE SHIELD
NY3001603OtherGHI
NY01080982Medicaid
NYCS115OtherOXFORD
NY2C4866OtherHEALTHNET
NY21E611OtherBLUE CROSS/ BLUE SHIELD
NYA61257Medicare UPIN