Provider Demographics
NPI:1629562335
Name:HINDS ALLEN, SHALIESHA K (MD)
Entity type:Individual
Prefix:DR
First Name:SHALIESHA
Middle Name:K
Last Name:HINDS ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 BRENTWOOD RD STE 201
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8031
Mailing Address - Country:US
Mailing Address - Phone:631-968-8288
Mailing Address - Fax:
Practice Address - Street 1:39 BRENTWOOD RD STE 201
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8031
Practice Address - Country:US
Practice Address - Phone:631-968-8288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY329654207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty