Provider Demographics
NPI:1023088648
Name:ZECHOWY, ALLEN C (MD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:C
Last Name:ZECHOWY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:500 GROVE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1761
Mailing Address - Country:US
Mailing Address - Phone:856-796-9200
Mailing Address - Fax:856-796-9397
Practice Address - Street 1:63 KRESSON ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034
Practice Address - Country:US
Practice Address - Phone:856-795-2000
Practice Address - Fax:856-795-3625
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA031964002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ130003783OtherMEDICARE ID
NJ0464201Medicaid
NJ024461C04Medicare PIN
C53423Medicare UPIN