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NPI Code Detail

MEDICARE: KRYSTAL BROWN

MEDICARE: KRYSTAL BROWN
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
1174400000XSpecialist1265750NY

General Provider Information

NPI Number : 1215643838
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL BROWN
Provider Business Mailing Address
First Line : 24902 JERICHO TPKE STE 2
Second Line :
City : FLORAL PARK
State : NY
Zip : 11001-4023
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 24902 JERICHO TPKE STE 2
Second Line :
City : FLORAL PARK
State : NY
Zip : 11001-4023
Country : US
Telephone Number : 347-391-4160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2023
Last Update Date : 10/11/2025

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Directions to “ KRYSTAL BROWN ” Practice Location

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