Provider Demographics
NPI:1356380489
Name:ALLEN, ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 SHERIDAN DR
Mailing Address - Street 2:STE 200
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1631
Mailing Address - Country:US
Mailing Address - Phone:716-876-5512
Mailing Address - Fax:716-876-7342
Practice Address - Street 1:4041 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150
Practice Address - Country:US
Practice Address - Phone:716-876-5512
Practice Address - Fax:716-876-7342
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205688207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000524718001OtherBLUE CROSS BLUE SHIELD
156780CKOtherPREFERRED CARE
0086173OtherGHI
NY01843407Medicaid
0709060OtherIHA
4055OtherUNIVERA PIN#
00010305501OtherUNIVERA
160035186OtherRAILROAD BLOCK 24K
160035186OtherRAILROAD BLOCK 24K
0709060OtherIHA
NY01843407Medicaid