Healthcare Provider Details

I. General information

NPI: 1942580709
Provider Name (Legal Business Name): ALICE HATTIE BROWNE SPECIAL EDUCATOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2011
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 GRAND STREET 2ND FLOOR
NEW YORK NY
10002
US

IV. Provider business mailing address

930 GRAND CONCOURSE 8H
BRONX NY
10451
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-1999
  • Fax: 212-420-1910
Mailing address:
  • Phone: 917-561-5385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number518040112
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: