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General NPI Number Information
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NPI Number | 1295877462
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Entity Type | Individual
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Provider Name | KIMBERLY FAHEY BROWN M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 450 PLANDOME RD
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City | MANHASSET
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State | NY
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Zip | 11030-1937
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Country | US
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Telephone | 516-627-6555
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Fax | 516-627-6651
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Provider Business Mailing Address
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Address Line | 1 SANDS LIGHT RD
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City | SANDS POINT
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State | NY
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Zip | 11050-1229
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Country | US
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Telephone | 516-767-3345
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Fax | 516-767-3365
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 226784
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License Number State | NY
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