Provider Demographics
NPI:1255900395
Name:ALLY ENDOCRINOLOGY PLLC
Entity type:Organization
Organization Name:ALLY ENDOCRINOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:VIN
Authorized Official - Middle Name:
Authorized Official - Last Name:P
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-825-3764
Mailing Address - Street 1:755 W BIG BEAVER RD STE 2020
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4925
Mailing Address - Country:US
Mailing Address - Phone:248-825-3764
Mailing Address - Fax:833-391-2161
Practice Address - Street 1:1380 COOLIDGE HWY STE 220
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7068
Practice Address - Country:US
Practice Address - Phone:248-825-3764
Practice Address - Fax:833-391-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty