Healthcare Provider Details

I. General information

NPI: 1497674071
Provider Name (Legal Business Name): DANIEL JOSEPH BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 NORTHERN BLVD STE 201
LONG ISLAND CITY NY
11101-2889
US

IV. Provider business mailing address

3030 NORTHERN BLVD STE 201
LONG ISLAND CITY NY
11101-2889
US

V. Phone/Fax

Practice location:
  • Phone: 347-446-0912
  • Fax: 718-888-6663
Mailing address:
  • Phone: 347-446-0912
  • Fax: 718-888-6663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: