Provider Demographics
NPI:1255609764
Name:ALLEN, ANOTHONY ERIC
Entity type:Individual
Prefix:
First Name:ANOTHONY
Middle Name:ERIC
Last Name:ALLEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 WRONDEL WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3701
Mailing Address - Country:US
Mailing Address - Phone:775-336-2812
Mailing Address - Fax:775-336-1082
Practice Address - Street 1:2470 WRONDEL WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3701
Practice Address - Country:US
Practice Address - Phone:775-336-2812
Practice Address - Fax:775-336-1082
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator