Provider Demographics
NPI:1205983715
Name:ALLEN, RICHARD L (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 TAYLORS MILLS RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3229
Mailing Address - Country:US
Mailing Address - Phone:732-780-7333
Mailing Address - Fax:732-358-0921
Practice Address - Street 1:227 TAYLORS MILLS RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3229
Practice Address - Country:US
Practice Address - Phone:732-780-7333
Practice Address - Fax:732-358-0921
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010584111N00000X
NJ38MC00624900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX7S031Medicare PIN
NYV03139Medicare UPIN
NJ140001Medicare PIN