Individual
JACQUELINE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2025 RICHMOND AVE, STATEN ISLAND, NY 10314-3937
(516) 434-0006
Mailing address
4 S LAKE DR, RED BANK, NJ 07701-5314
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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