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General NPI Number Information
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NPI Number | 1154116168
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Entity Type | Organization
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Legal Business Name | CITIZEN HEALTH PA
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 175 S 3RD ST STE 200
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City | COLUMBUS
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State | OH
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Zip | 43215-5194
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Country | US
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Telephone | 844-451-0472
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Fax |
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Provider Business Mailing Address
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Address Line | 175 S 3RD ST STE 200
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City | COLUMBUS
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State | OH
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Zip | 43215-5194
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED PERSON
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Name | KAMARR BROWN
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Credential |
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Telephone | 215-709-5670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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