Healthcare Provider Details

I. General information

NPI: 1336353028
Provider Name (Legal Business Name): KATHLEEN ANN BROWN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 GRASSLANDS RD
VALHALLA NY
10595-1646
US

IV. Provider business mailing address

20 GRAND STREET, 3RD FL
WARWICK NY
10990-1035
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7689
  • Fax: 914-493-1203
Mailing address:
  • Phone: 845-987-3901
  • Fax: 845-987-5979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number303801
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: