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General NPI Number Information
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NPI Number | 1700450558
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Entity Type | Organization
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Legal Business Name | ALLARA MEDICAL GROUP PA
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 9744 AVENEL FARM DR
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City | POTOMAC
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State | MD
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Zip | 20854-5407
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Country | US
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Telephone | 240-988-3611
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Fax |
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Provider Business Mailing Address
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Address Line | 520 BROADWAY FL 7
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City | NEW YORK
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State | NY
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Zip | 10012-4436
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Country | US
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Telephone | 201-564-5109
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. KENNETH ALAN BLANK
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Credential | MD
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Telephone | 240-432-5123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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