=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689979437
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CYRIL A ALLEN MD LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2011
-----------------------------------------------------
Last Update Date | 01/25/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1328 SOUTHERN AVE SE 202
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20032-4689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-574-6141
-----------------------------------------------------
Fax | 202-373-5956
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8205 WATERSIDE CT
-----------------------------------------------------
City | FORT WASHINGTON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20744-5571
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-309-1848
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE MBR
-----------------------------------------------------
Name | CYRIL ANTHONY ALLEN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 202-574-6141
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | MD33401
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------