Healthcare Provider Details
I. General information
NPI: 1023981370
Provider Name (Legal Business Name): BROWN MEDICAL PRACTICE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/24/2025
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2248 BROADWAY
NEW YORK NY
10024-5805
US
IV. Provider business mailing address
2248 BROADWAY # 1684
NEW YORK NY
10024-5805
US
V. Phone/Fax
- Phone: 213-267-0123
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TAKASHI
NAKAMURA
Title or Position: PRESIDENT, TREASURER, AND SECRETARY
Credential: MD
Phone: 808-258-2370