Individual
JEONG L ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3326
(215) 707-8028
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-7200
(215) 707-8028
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
26NR14782200
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
90604
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NR14782200
NJ MEDICAL LICENSE
NJ
01
—
RN584999
PA DEPARTMENT OF STATE
PA
Enumeration date
08/01/2012
Last updated
02/16/2017
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