Healthcare Provider Details

I. General information

NPI: 1720333453
Provider Name (Legal Business Name): AKILAH ALLEYNE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17810 WEXFORD TER
JAMAICA NY
11432-3050
US

IV. Provider business mailing address

2190 MADISON AVE 3F
NEW YORK NY
10037-2205
US

V. Phone/Fax

Practice location:
  • Phone: 718-658-1123
  • Fax: 718-658-7091
Mailing address:
  • Phone: 785-554-7460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: