Healthcare Provider Details

I. General information

NPI: 1891756417
Provider Name (Legal Business Name): JONATHAN DAVID ALLEN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 BROADWAY STE 1605
NEW YORK NY
10007-3756
US

IV. Provider business mailing address

225 BROADWAY STE 1605
NEW YORK NY
10007-3756
US

V. Phone/Fax

Practice location:
  • Phone: 212-227-2225
  • Fax: 212-227-2397
Mailing address:
  • Phone: 212-227-2225
  • Fax: 212-227-2397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9053
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: