Healthcare Provider Details

I. General information

NPI: 1437426889
Provider Name (Legal Business Name): ALLIED PHYSICIANS GROUP PEDIATRIC AFTER HOURS CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2011
Last Update Date: 10/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 N BROADWAY
JERICHO NY
11753-2115
US

IV. Provider business mailing address

68 S SERVICE RD STE. 350
MELVILLE NY
11747-2354
US

V. Phone/Fax

Practice location:
  • Phone: 866-621-2769
  • Fax:
Mailing address:
  • Phone: 516-945-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN ENGLER
Title or Position: VICE PRESIDENT CONTRACTING AND PHYS
Credential:
Phone: 516-945-3000