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General NPI Number Information
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NPI Number | 1508820119
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Entity Type | Individual
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Provider Name | MICHAEL J BROWN PA
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Gender | Male
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 100 WHITE SPRUCE BLVD DERMATOLOGY ASSOCIATES OF ROCHESTER PC
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City | ROCHESTER
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State | NY
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Zip | 14623-1507
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Country | US
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Telephone | 585-272-0700
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Fax | 585-697-0822
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Provider Business Mailing Address
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Address Line | 1815 CLINTON AVE S STE 530
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City | ROCHESTER
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State | NY
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Zip | 14618-5721
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Country | US
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Telephone | 585-442-4310
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Fax | 585-442-6750
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 000051
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License Number State | NY
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