Provider Demographics
NPI:1205098118
Name:CHENEY, ALLISON LEE (DPM)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:LEE
Last Name:CHENEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 83
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07750
Mailing Address - Country:US
Mailing Address - Phone:732-695-3668
Mailing Address - Fax:732-784-4286
Practice Address - Street 1:1803 HWY 35
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2974
Practice Address - Country:US
Practice Address - Phone:732-695-3668
Practice Address - Fax:732-784-4286
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00323400213E00000X, 213EP1101X, 213ES0000X, 213ES0103X, 213ES0131X
AZ0681213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
6177070001Medicare NSC