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General NPI Number Information
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NPI Number | 1730432394
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Entity Type | Organization
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Legal Business Name | LEW BROWN,PH.D. PSYCHOLOGIST PLLC
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 68 SAINT MARKS PL
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City | BROOKLYN
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State | NY
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Zip | 11217-1945
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Country | US
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Telephone | 718-834-1646
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 170297
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City | BROOKLYN
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State | NY
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Zip | 11217-0297
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Country | US
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Telephone | 718-834-1646
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. LEWIS MICHAEL BROWN
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Credential | PH.D.
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Telephone | 718-834-1646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 09119-1
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License Number State | NY
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