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General NPI Number Information
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NPI Number | 1518622299
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Entity Type | Individual
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Provider Name | CASSANDRA BROWN RN,LENS PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 11/08/2021
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 201 S 2ND ST
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City | FULTON
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State | NY
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Zip | 13069-2346
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Country | US
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Telephone | 315-297-4018
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Fax |
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Provider Business Mailing Address
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Address Line | 201 S 2ND ST
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City | FULTON
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State | NY
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Zip | 13069-2346
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Country | US
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Telephone | 315-297-4018
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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 | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 692040
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 692040
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 692040
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 692040
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 246ZE0500X
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Taxonomy Name | EEG Specialist/Technologist
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License Number |
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | NY
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