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General NPI Number Information
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NPI Number | 1013808781
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Entity Type | Individual
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Provider Name | WILBERT BROWN
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Gender | Male
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 860 WILLOUGHBY AVE
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City | BROOKLYN
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State | NY
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Zip | 11221-6778
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Country | US
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Telephone | 202-820-0014
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Fax |
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Provider Business Mailing Address
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Address Line | 440 BEACH 54TH ST
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City | ARVERNE
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State | NY
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Zip | 11692-1544
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Country | US
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Telephone | 202-820-0014
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 029951
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License Number State | NY
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