MEDICARE: MATTHEW BROWN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	237037	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01518964	OTHER	NY	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396780359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW BROWN MD

Provider Business Mailing Address
First Line	:	100 KINGS HWY S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-5504
Country	:	US
Telephone Number	:	585-368-3031
Fax Number	:	585-368-3037

Provider Business Practice Location Address
First Line	:	55 GENESEE ST
Second Line	:	BISHOP KEARNEY BUILDING, 3RD FLOOR
City	:	ROCHESTER
State	:	NY
Zip	:	14611-3201
Country	:	US
Telephone Number	:	585-368-3031
Fax Number	:	585-368-3037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	04/15/2021

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