Provider Demographics
NPI:1801061189
Name:ALLAN, MICHELE C (NP)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:C
Last Name:ALLAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2432
Mailing Address - Country:US
Mailing Address - Phone:516-294-1050
Mailing Address - Fax:516-294-1758
Practice Address - Street 1:233 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2432
Practice Address - Country:US
Practice Address - Phone:516-294-1050
Practice Address - Fax:516-294-1758
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360387-1364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health