MEDICARE: DR. ALICE BROWN BRANDWEIN PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist

General Provider Information

NPI Number	:	1154829000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICE BROWN BRANDWEIN PHD

Provider Business Mailing Address
First Line	:	30 FAIRVIEW AVE FL 2
Second Line	:
City	:	TUCKAHOE
State	:	NY
Zip	:	10707-4144
Country	:	US
Telephone Number	:	917-597-1629
Fax Number	:

Provider Business Practice Location Address
First Line	:	445 PARK AVE FL 2
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-8649
Country	:	US
Telephone Number	:	646-625-4359
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2018
Last Update Date	:	01/25/2018

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