Provider Demographics
NPI:1538228986
Name:ALLEN, MARY ANN
Entity type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 ALUMINUM CITY TER
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-5079
Mailing Address - Country:US
Mailing Address - Phone:724-339-1422
Mailing Address - Fax:724-339-7369
Practice Address - Street 1:2300 FREEPORT RD
Practice Address - Street 2:SUITE 25 FELDARELLI SQUARE
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-4669
Practice Address - Country:US
Practice Address - Phone:724-339-6631
Practice Address - Fax:724-339-7369
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT001024L231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1417985151Medicare UPIN