Healthcare Provider Details

I. General information

NPI: 1760979728
Provider Name (Legal Business Name): NATHANIEL ALLISON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 05/21/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JAMAICA HOSPITAL MEDICAL CENTER 8900 VAN WYCK EXPRESSWAY
RICHMOND HILL NY
11418
US

IV. Provider business mailing address

JAMAICA HOSPITAL MEDICAL CENTER 8900 VAN WYCK EXPRESSWAY
RICHMOND HILL NY
11418
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-6000
  • 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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB11284300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number334606
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: