MEDICARE: DR. DENYSE MARIE ALLEN M.D.

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	207Q00000X	Family Medicine Physician	170213	NY
2	2083P0901X	Public Health & General Preventive Medicine Physician	MD-032127-E	PA
3	207Q00000X	Family Medicine Physician	MD-032127-E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03212100	OTHER	PA	BLUE CROSS-KEYSTONE
2	488777	OTHER	PA	BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720137177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENYSE MARIE ALLEN M.D.

Provider Business Mailing Address
First Line	:	1701 CORNWALL RD STE 201
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-7480
Country	:	US
Telephone Number	:	717-675-1780
Fax Number	:	717-675-1787

Provider Business Practice Location Address
First Line	:	1701 CORNWALL RD STE 201
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-7480
Country	:	US
Telephone Number	:	717-675-1780
Fax Number	:	717-675-1787

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	03/03/2020

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