Individual provider · NPI-1

Jennifer Dyane Allen, NP

Nurse Practitioner, Pediatrics · New York, NY

NPI number1982010260
StatusActive
Last updated in NPPESNov 25, 2015

Details

NPI
1982010260
Entity type
Individual (NPI-1)
Name
Jennifer Dyane Allen
Credential
NP
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 7, 2014
Last updated
Nov 25, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsF382526-1NYYes
163WP0218X Registered Nurse, Pediatric Oncology649661NY

Practice location

3959 Broadway
New York, NY 10032-1559

Phone 212-343-8530

Mailing address

580 Saint Nicholas Ave Apt 4h
New York, NY 10030-1932

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