Healthcare Provider Details

I. General information

NPI: 1770112278
Provider Name (Legal Business Name): JOSHUA VAN ALLEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 COVENTRY ST FL 2
HARTFORD CT
06112-1548
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 860-714-3690
  • Fax: 860-714-8541
Mailing address:
  • Phone: 717-851-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberOS025554
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: