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NPI Code Detail

MEDICARE: JUSTIN BROWN MD

MEDICARE:   JUSTIN  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
1207N00000XDermatology Physician25MA08113700NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125MA08113700OTHERNJSTATE LICENSE
21962428474OTHERNJGROUP PRACTICE #

General Provider Information

NPI Number : 1740375310
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN BROWN MD
Provider Business Mailing Address
First Line : 60 POMPTON AVE
Second Line :
City : VERONA
State : NJ
Zip : 07044-2946
Country : US
Telephone Number : 973-571-2121
Fax Number :
Provider Business Practice Location Address
First Line : 60 POMPTON AVE
Second Line :
City : VERONA
State : NJ
Zip : 07044-2946
Country : US
Telephone Number : 973-571-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 07/08/2007

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Directions to “ JUSTIN BROWN MD” Practice Location

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