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NPI Code Detail

MEDICARE: DR. RICHARD G ALLEN PSYD, BCBA-D, NCSP

MEDICARE: DR. RICHARD G ALLEN PSYD, BCBA-D, NCSP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-06-3160PA
2103TC0700XClinical PsychologistB1-0001038DE
3103TC0700XClinical Psychologist35100664700NJ
4103TC0700XClinical PsychologistPS017761PA

General Provider Information

NPI Number : 1063747764
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD G ALLEN PSYD, BCBA-D, NCSP
Provider Business Mailing Address
First Line : 35 KINGS CT
Second Line :
City : SWEDESBORO
State : NJ
Zip : 08085-5033
Country : US
Telephone Number : 856-264-6099
Fax Number :
Provider Business Practice Location Address
First Line : 510 PHILADELPHIA PIKE
Second Line :
City : WILMINGTON
State : DE
Zip : 19809-2100
Country : US
Telephone Number : 877-834-9302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2009
Last Update Date : 05/24/2022

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