Healthcare Provider Details

I. General information

NPI: 1861076671
Provider Name (Legal Business Name): ARIEL ALLEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 WATERS PLACE TOWER 1 PH, DEPARTMENT OF UROLOGY
BRONX NY
10461
US

IV. Provider business mailing address

321 W 94TH ST
NEW YORK NY
10025-6860
US

V. Phone/Fax

Practice location:
  • Phone: 678-982-8175
  • Fax:
Mailing address:
  • Phone: 678-982-8175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number341848
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: