Healthcare Provider Details

I. General information

NPI: 1730401167
Provider Name (Legal Business Name): JULIEN ALLEYNE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2010
Last Update Date: 02/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8268 164 STREET
JAMAICA NY
11432
US

IV. Provider business mailing address

82 -68-164 ST
JAMAICA NY
11432
US

V. Phone/Fax

Practice location:
  • Phone: 718-883-3888
  • Fax: 718-883-6195
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0359631
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: