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Individual

JENNIFER DYANE ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 343-8530
Mailing address
580 SAINT NICHOLAS AVE APT 4H, NEW YORK, NY 10030-1932

Taxonomy

Speciality
Code
Description
License number
State
163WP0218X
Pediatric Oncology Registered Nurse
649661
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F382526-1
NY

Other

Enumeration date
07/07/2014
Last updated
11/25/2015
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