Healthcare Provider Details

I. General information

NPI: 1588788186
Provider Name (Legal Business Name): ALLEN DAVID MEISEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E 94TH ST
NEW YORK NY
10128-1913
US

IV. Provider business mailing address

1170 5TH AVE PH-A
NEW YORK NY
10029-6527
US

V. Phone/Fax

Practice location:
  • Phone: 917-647-0976
  • Fax: 212-427-2031
Mailing address:
  • Phone: 917-647-0976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number106087
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number106087
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number106087
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: