Healthcare Provider Details

I. General information

NPI: 1669457735
Provider Name (Legal Business Name): REBECCA H ALLEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 DUDLEY ST
PROVIDENCE RI
02905-2401
US

IV. Provider business mailing address

101 DUDLEY ST
PROVIDENCE RI
02905-2401
US

V. Phone/Fax

Practice location:
  • Phone: 401-274-1122
  • Fax:
Mailing address:
  • Phone: 401-274-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD12345
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number223972
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: