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General NPI Number Information
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NPI Number | 1982392049
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Entity Type | Individual
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Provider Name | ALLISON ISRAEL PA
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Gender | Female
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 244 WESTERN AVE
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2496
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Country | US
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Telephone | 207-775-3446
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Fax | 207-879-4188
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Provider Business Mailing Address
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Address Line | 244 WESTERN AVE
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2496
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Country | US
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Telephone | 207-775-3446
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Fax | 207-879-4188
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA2749
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License Number State | ME
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