Provider Demographics
NPI:1972601128
Name:ELKIN, ALLEN JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:JOSEPH
Last Name:ELKIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E 36TH ST
Mailing Address - Street 2:STE 1-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:18016-3464
Mailing Address - Country:US
Mailing Address - Phone:212-679-4819
Mailing Address - Fax:212-679-4819
Practice Address - Street 1:110 E 36TH ST
Practice Address - Street 2:STE 1-C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:18016-3464
Practice Address - Country:US
Practice Address - Phone:212-679-4819
Practice Address - Fax:212-679-4819
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5294103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV21641Medicare ID - Type Unspecified