1346294568 NPI number — DAVID W ALLEN M D P C

Table of content: PATRICK COLBY WALSH MS. PAC (NPI 1912312166)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346294568 NPI number — DAVID W ALLEN M D P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVID W ALLEN M D P C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346294568
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 PARK PLZ
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
WYOMISSING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19610-1398
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-372-3002
Provider Business Mailing Address Fax Number:
610-372-3007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 PARK PLZ
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
WYOMISSING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19610-1398
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-372-3002
Provider Business Practice Location Address Fax Number:
610-372-3007
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HESS
Authorized Official First Name:
CHRISTINE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
610-372-3002

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1109060 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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