Provider Demographics
NPI:1265554349
Name:ALLAN, DAVID E (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:ALLAN
Suffix:
Gender:M
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 434
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11002-0434
Mailing Address - Country:US
Mailing Address - Phone:516-395-2800
Mailing Address - Fax:
Practice Address - Street 1:493 E 138 ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454
Practice Address - Country:US
Practice Address - Phone:718-993-2633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN0040531213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0079048OtherGHI
NY00992365Medicaid
1035160001OtherCMS
NYP45293Medicare ID - Type Unspecified
NY0079048OtherGHI
T51436Medicare UPIN
NYP45291Medicare ID - Type Unspecified