Provider Demographics
NPI:1881371896
Name:ALLAY, SAMUEL JAMESON (DO)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JAMESON
Last Name:ALLAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 15245 BOX BRIAN
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96271-5245
Mailing Address - Country:US
Mailing Address - Phone:315-737-3541
Mailing Address - Fax:
Practice Address - Street 1:UNIT 15245 BOX BRIAN
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96271-5245
Practice Address - Country:US
Practice Address - Phone:315-737-3541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333729208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice