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NPI Code Detail

MEDICARE: LANCE JEFFERY BROWNSTEIN MD

MEDICARE: LANCE JEFFERY BROWNSTEIN 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
1207R00000XInternal Medicine Physician188067NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417946963
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANCE JEFFERY BROWNSTEIN MD
Provider Business Mailing Address
First Line : 34 CHENANGO AVE
Second Line :
City : CLINTON
State : NY
Zip : 13323-1341
Country : US
Telephone Number : 315-853-5550
Fax Number : 315-853-5581
Provider Business Practice Location Address
First Line : 34 CHENANGO AVE
Second Line :
City : CLINTON
State : NY
Zip : 13323-1341
Country : US
Telephone Number : 315-853-5550
Fax Number : 315-853-5581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 05/30/2013

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