Individual
ALLEN LAURENCE CARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1367 WASHINGTON AVE, STE 200, ALBANY, NY 12206-1043
(518) 489-2666
(518) 489-5933
Mailing address
1367 WASHINGTON AVE, STE 200, ALBANY, NY 12206-1043
(518) 489-2666
(518) 489-5933
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
143645
NY
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
143645-0
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000406266006
BS NENY
NY
05
—
00964094
—
NY
01
—
10006085
CDPHP
NY
01
—
18314
MVP
NY
01
—
4591431
AETNA
NY
01
—
84G891
EMPIRE BC
NY
Enumeration date
06/15/2005
Last updated
02/25/2008
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