=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013119478
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARTIN A BROWN D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29 E MILL RD
-----------------------------------------------------
City | NORTHFIELD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08225-2551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-641-6880
-----------------------------------------------------
Fax | 609-383-1361
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 29 E MILL RD
-----------------------------------------------------
City | NORTHFIELD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08225-2551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-641-6880
-----------------------------------------------------
Fax | 609-383-1361
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 001263
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------