Provider Demographics
NPI:1891083150
Name:PROBER, ALLEN S (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:S
Last Name:PROBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:320 ROBINSON AVENUE
Mailing Address - Street 2:C/O ORANGE RADIOLOGY ASSOCIATES
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3353
Mailing Address - Country:US
Mailing Address - Phone:845-565-1254
Mailing Address - Fax:845-492-2118
Practice Address - Street 1:1 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922
Practice Address - Country:US
Practice Address - Phone:908-277-8673
Practice Address - Fax:908-277-8774
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2879982085R0202X
NJ25MA101776002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty