Healthcare Provider Details

I. General information

NPI: 1225058381
Provider Name (Legal Business Name): DENNIS J ALLENDORF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
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

46 BENJAMIN RD
TENAFLY NJ
07670-2618
US

V. Phone/Fax

Practice location:
  • Phone: 212-666-4610
  • Fax: 212-666-3173
Mailing address:
  • Phone: 201-568-0955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number111809
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: