MEDICARE: MICHAEL J BROWN PA

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	363A00000X	Physician Assistant
2	363AM0700X	Medical Physician Assistant	000051	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1508820119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J BROWN PA

Provider Business Mailing Address
First Line	:	1815 CLINTON AVE S
Second Line	:	STE 530
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5721
Country	:	US
Telephone Number	:	585-442-4310
Fax Number	:	585-442-6750

Provider Business Practice Location Address
First Line	:	100 WHITE SPRUCE BLVD
Second Line	:	DERMATOLOGY ASSOCIATES OF ROCHESTER PC
City	:	ROCHESTER
State	:	NY
Zip	:	14623-1507
Country	:	US
Telephone Number	:	585-272-0700
Fax Number	:	585-697-0822

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	03/11/2022

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