MEDICARE: ERYN RENAE 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

General Provider Information

NPI Number	:	1548009855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERYN RENAE BROWN PA

Provider Business Mailing Address
First Line	:	1775 NIAGARA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14207-3110
Country	:	US
Telephone Number	:	716-332-4472
Fax Number	:	716-332-4474

Provider Business Practice Location Address
First Line	:	1775 NIAGARA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14207-3110
Country	:	US
Telephone Number	:	716-332-4472
Fax Number	:	716-332-4474

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

Provider Enumeration Date	:	05/24/2024
Last Update Date	:	10/14/2025

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