Healthcare Provider Details

I. General information

NPI: 1497508055
Provider Name (Legal Business Name): ALLSTATE DME CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 AVENUE P FL 1
BROOKLYN NY
11204-4946
US

IV. Provider business mailing address

261 AVENUE P FL 1
BROOKLYN NY
11204-4946
US

V. Phone/Fax

Practice location:
  • Phone: 347-322-2497
  • Fax:
Mailing address:
  • Phone: 347-322-2497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: RAQUEL GRAY
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 347-970-0500