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General NPI Number Information
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NPI Number | 1518501485
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Entity Type | Individual
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Provider Name | SHANNON BROWN RPSGT
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Gender | Female
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 410 LAKEVILLE RD STE 107
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1102
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Country | US
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Telephone | 516-465-5346
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Fax | 516-465-5454
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Provider Business Mailing Address
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Address Line | 155 COMMUNITY DR
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City | GREAT NECK
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State | NY
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Zip | 11021-5502
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Country | US
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Telephone | 516-465-8270
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Fax | 516-465-8274
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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 | 174H00000X
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Taxonomy Name | Health Educator
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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 | 225500000X
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Taxonomy Name | Respiratory/Developmental/Rehabilitative Specialist/Technologist
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License Number | 000451
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License Number State | NY
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