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General NPI Number Information
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NPI Number | 1083780514
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Entity Type | Individual
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Provider Name | LINCOLN DARIUS ALLEN PA
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 785 WESTCHESTER AVENUE
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City | BRONX
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State | NY
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Zip | 10455
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Country | US
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Telephone | 718-589-5500
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Fax | 718-589-1096
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Provider Business Mailing Address
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Address Line | 324 PALISADE AVE SUITE#1C
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City | YONKERS
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State | NY
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Zip | 10703-2924
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Country | US
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Telephone | 914-377-1191
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 000366
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License Number State | NY
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