| Shawn Allen Md Pllc | |
|
646 Main St Ste 102 Port Jefferson NY 11777-2230 | |
| (917) 740-1381 | |
| Not Available |
| Full Name | Shawn Allen Md Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 646 Main St Ste 102, Port Jefferson, New York |
| Authorized Official Name and Position | Shawn Michael Allen (OWNER) |
| Authorized Official Contact | 9177401381 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawn Allen Md Pllc 646 Main St Ste 102 Port Jefferson NY 11777-2230 Ph: () - | Shawn Allen Md Pllc 646 Main St Ste 102 Port Jefferson NY 11777-2230 Ph: (917) 740-1381 |
| NPI Number | 1578213906 |
|---|---|
| Provider Enumeration Date | 03/28/2022 |
| Last Update Date | 03/28/2022 |
| Certification Date | 03/28/2022 |
| Medicare PECOS PAC ID | 7517354939 |
|---|---|
| Medicare Enrollment ID | O20220503001077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578213906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Shawn M Allen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548423577 PECOS PAC ID: 4486770468 Enrollment ID: I20140410001907 |
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