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General NPI Number Information
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NPI Number | 1841653763
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Entity Type | Individual
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Provider Name | ANDREW P BROWN III PH.D
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Gender | Male
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 31 CLINTON ST
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City | NEWARK
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State | NJ
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Zip | 07102-3729
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Country | US
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Telephone | 732-389-0111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8053
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City | RED BANK
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State | NJ
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Zip | 07701-8053
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Country | US
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Telephone | 732-389-0111
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 35SI00290400
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License Number State | NJ
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