Healthcare Provider Details
I. General information
NPI: 1326501768
Provider Name (Legal Business Name): DR SCOTT G BROWN DO PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/11/2019
Last Update Date: 03/08/2022
Certification Date: 03/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2374 JERUSALEM AVE
NORTH BELLMORE NY
11710-1825
US
IV. Provider business mailing address
2374 JERUSALEM AVE
NORTH BELLMORE NY
11710-1825
US
V. Phone/Fax
- Phone: 516-409-8311
- Fax: 516-409-8313
- Phone: 516-409-8311
- Fax: 516-409-8313
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SCOTT
G
BROWN
Title or Position: OWNER
Credential: DO
Phone: 516-406-8311