Healthcare Provider Details

I. General information

NPI: 1184549479
Provider Name (Legal Business Name): JASON ALLER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 E MAIN ST
MIDDLETOWN NY
10940-2650
US

IV. Provider business mailing address

314 LONG LN
BLOOMINGBURG NY
12721-3156
US

V. Phone/Fax

Practice location:
  • Phone: 845-333-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number933622
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: