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NPI 1740293265

NPI 1740293265 : LAWRENCE OWEN BROWN PH.D. : LARCHMONT, NY

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General NPI Number Information
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    NPI Number           |    1740293265
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    Entity Type          |    Individual 
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    Provider Name        |    LAWRENCE OWEN BROWN PH.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/14/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    71 BEACH AVE 
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    City                 |    LARCHMONT
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    State                |    NY
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    Zip                  |    10538-4030
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    Country              |    US
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    Telephone            |    914-833-2133
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    Fax                  |    914-833-2133
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Provider Business Mailing Address
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    Address Line         |    71 BEACH AVE 
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    City                 |    LARCHMONT
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    State                |    NY
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    Zip                  |    10538-4030
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    Country              |    US
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    Telephone            |    914-833-2133
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    Fax                  |    914-833-2133
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    4640
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    License Number State |    NY
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