Basic Information
Provider Information
NPI: 1003800236
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLOWAY
FirstName: JANET
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 14890
Address2:  
City: ALBANY
State: NY
PostalCode: 122124890
CountryCode: US
TelephoneNumber: 5185255634
FaxNumber: 5186494094
Practice Location
Address1: 2215 BURDETT AVE
Address2:  
City: TROY
State: NY
PostalCode: 12180
CountryCode: US
TelephoneNumber: 5182713300
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/02/2005
LastUpdateDate: 04/23/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X006067NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363AM0700X006067NYN Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

ID Information
IDTypeStateIssuerDescription
0262305405NY MEDICAID


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