Healthcare Provider Details

I. General information

NPI: 1417137654
Provider Name (Legal Business Name): RONA YVELYSE ALLEN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 SCHUYLER RD
BLAUVELT NY
10960
US

IV. Provider business mailing address

PO BOX 6139
NEW YORK NY
10150-6139
US

V. Phone/Fax

Practice location:
  • Phone: 646-642-9997
  • Fax: 201-482-0350
Mailing address:
  • Phone: 646-642-9997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX0067441
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: