MEDICARE: ALBERT A. ALLEY, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MD009878E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104847193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBERT A. ALLEY, LTD

Provider Business Mailing Address
First Line	:	1510 CORNWALL RD
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-7479
Country	:	US
Telephone Number	:	717-273-0662
Fax Number	:	717-270-9810

Provider Business Practice Location Address
First Line	:	1510 CORNWALL RD
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-7479
Country	:	US
Telephone Number	:	717-273-0662
Fax Number	:	717-270-9810

Authorized Official
Title or Position	:	OPHTHALMOLOGIST
Name	:	DR. ALBERT A ALLEY
Credential	:	M.D.
Telephone Number	:	717-273-0662

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	01/25/2008

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