Provider Demographics
NPI:1659418556
Name:ALLEN, JOHN RAYMOND (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RAYMOND
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2433 COUNTY ROAD 516
Mailing Address - Street 2:SUITEA
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1892
Mailing Address - Country:US
Mailing Address - Phone:732-679-6880
Mailing Address - Fax:732-679-7336
Practice Address - Street 1:2433 COUNTY ROAD 516
Practice Address - Street 2:SUITEA
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1892
Practice Address - Country:US
Practice Address - Phone:732-679-6880
Practice Address - Fax:732-679-7336
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ01422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0783645OtherAETNA
NJ90053022OtherCIGNAPPO
NJMC001422OtherHIP NEW YORK
NJP1595719OtherOXFORD
NJ0031275OtherGHI
NJ459758OtherUNITED HEALTHCARE
NJX4A511OtherEMPIRE HEALTH
NJ0691997000OtherAMERIHEALTH
NJ90053022003OtherHMO
NJMC001422OtherHIP NEW YORK