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NPI Code Detail

MEDICARE: DR. EDEN BROWN PSY.D.

MEDICARE: DR. EDEN BROWN PSY.D.
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
1103TC0700XClinical Psychologist0812-002442VA
2103TC0700XClinical Psychologist0810-02442VA
3103TC0700XClinical Psychologist1414NH

General Provider Information

NPI Number : 1518087691
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDEN BROWN PSY.D.
Provider Business Mailing Address
First Line : PO BOX 1595
Second Line :
City : MIDDLETOWN
State : CT
Zip : 06457-8095
Country : US
Telephone Number : 860-788-6404
Fax Number :
Provider Business Practice Location Address
First Line : 10 FERRY ST STE 313
Second Line :
City : CONCORD
State : NH
Zip : 03301-5004
Country : US
Telephone Number : 860-788-6404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 02/11/2025

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