Healthcare Provider Details

I. General information

NPI: 1639865447
Provider Name (Legal Business Name): DANIA ALLEN DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 HAMBURG TPKE STE 108
WAYNE NJ
07470-2033
US

IV. Provider business mailing address

510 HAMBURG TPKE STE 108
WAYNE NJ
07470-2033
US

V. Phone/Fax

Practice location:
  • Phone: 973-925-4111
  • Fax:
Mailing address:
  • Phone: 973-925-4111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00391700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: