Healthcare Provider Details

I. General information

NPI: 1598554990
Provider Name (Legal Business Name): NICO SCOTT BROWN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/02/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MEMORIAL DRIVE
FARRELL PA
16121
US

IV. Provider business mailing address

3600 FORBES AVENUE FORBES TOWER PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 724-528-2513
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberHS000288L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: