Individual
DEANNA RAYMOND ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A
Contact information
Practice address
100 CLINTON ST, FAYETTEVILLE, NY 13066-2045
(315) 218-5909
Mailing address
100 CLINTON ST, FAYETTEVILLE, NY 13066-2045
(315) 218-5909
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
06572-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336163963
—
NY
Enumeration date
06/02/2006
Last updated
10/29/2025
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