Healthcare Provider Details

I. General information

NPI: 1669466389
Provider Name (Legal Business Name): LORI BROWN-HALBERT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 03/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 NORTH RD STE 304
POUGHKEEPSIE NY
12601-1173
US

IV. Provider business mailing address

111 CLOCK TOWER CMNS STE 303
BREWSTER NY
10509-4055
US

V. Phone/Fax

Practice location:
  • Phone: 845-471-9410
  • Fax: 845-471-7943
Mailing address:
  • Phone: 845-592-4915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number488777
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: