MEDICARE: DR. ALLEN JOSHUA MAYER MD

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	208000000X	Pediatrics Physician	163289	NY

General Provider Information

NPI Number	:	1326052770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEN JOSHUA MAYER MD

Provider Business Mailing Address
First Line	:	38 ARLINGTON AVE
Second Line	:
City	:	KENSINGTON
State	:	CA
Zip	:	94707
Country	:	US
Telephone Number	:	718-630-7499
Fax Number	:	718-630-6877

Provider Business Practice Location Address
First Line	:	38 ARLINGTON AVE
Second Line	:
City	:	KENSINGTON
State	:	CA
Zip	:	94707
Country	:	US
Telephone Number	:	347-410-1028
Fax Number	:	718-630-6877

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	03/12/2014

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