Provider Demographics
NPI:1881384469
Name:ALLEN, DONALD (PCA)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-2068
Mailing Address - Country:US
Mailing Address - Phone:339-222-0811
Mailing Address - Fax:
Practice Address - Street 1:518 TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-2068
Practice Address - Country:US
Practice Address - Phone:339-222-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA043442703374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide