Provider Demographics
NPI:1891337424
Name:ALLEN, ANTHONY JR
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:ALLEN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 LOOKER ST
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2818
Mailing Address - Country:US
Mailing Address - Phone:908-355-3215
Mailing Address - Fax:
Practice Address - Street 1:51 LOOKER ST
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-2818
Practice Address - Country:US
Practice Address - Phone:908-355-3215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver