Provider Demographics
NPI:1184817884
Name:ALLEN, SHANNON LESLIE (MD)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LESLIE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 CENTRE AVE
Mailing Address - Street 2:#1903
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-3537
Mailing Address - Country:US
Mailing Address - Phone:717-576-1769
Mailing Address - Fax:
Practice Address - Street 1:4105 MONROEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2607
Practice Address - Country:US
Practice Address - Phone:412-380-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT1906352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry