Provider Demographics
NPI:1679957575
Name:ALLEN, NEOLETTE (RN)
Entity Type:Individual
Prefix:
First Name:NEOLETTE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1477 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1906
Mailing Address - Country:US
Mailing Address - Phone:718-979-6900
Mailing Address - Fax:718-979-6940
Practice Address - Street 1:133 SIMONSON AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-2550
Practice Address - Country:US
Practice Address - Phone:917-829-1072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY702049163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse