| Theodore Allen Physician, Pc | |
|
92 E Old Country Rd Hicksville NY 11801-4217 | |
| (516) 681-2700 | |
| (516) 681-7115 |
| Full Name | Theodore Allen Physician, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 92 E Old Country Rd, Hicksville, New York |
| Authorized Official Name and Position | Theodore Allen (PRESIDENT) |
| Authorized Official Contact | 5166812700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theodore Allen Physician, Pc 92 E Old Country Rd Hicksville NY 11801-4217 Ph: (516) 681-2700 | Theodore Allen Physician, Pc 92 E Old Country Rd Hicksville NY 11801-4217 Ph: (516) 681-2700 |
| NPI Number | 1083912216 |
|---|---|
| Provider Enumeration Date | 03/11/2011 |
| Last Update Date | 03/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083912216 | NPI | - | NPPES |
| 00238188 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 129095 (New York) | Primary |
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