Healthcare Provider Details

I. General information

NPI: 1164449179
Provider Name (Legal Business Name): DENNIS J ALLENDORF M.D. & J.P. PLENO MOISE M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W 118TH ST APT 2
NEW YORK NY
10027-7216
US

IV. Provider business mailing address

401 W 118TH ST APT 2
NEW YORK NY
10027-7216
US

V. Phone/Fax

Practice location:
  • Phone: 212-666-4610
  • Fax: 212-666-3173
Mailing address:
  • Phone: 212-666-4610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CINDY DIAZ
Title or Position: OFFICE MANAGER
Credential: M.D.
Phone: 212-666-4610