Provider Demographics
NPI:1871142059
Name:JIANG, ALLEN
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:JIANG
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 1:13631 41ST AVE PH
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2444
Mailing Address - Country:US
Mailing Address - Phone:718-496-9967
Mailing Address - Fax:718-939-3337
Practice Address - Street 1:13631 41ST AVE PH
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2444
Practice Address - Country:US
Practice Address - Phone:718-496-9967
Practice Address - Fax:718-939-3337
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi