MEDICARE: DR. JEFFREY A BROWN M.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
1	174400000X	Specialist	125871	NY

General Provider Information

NPI Number	:	1972792232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY A BROWN M.D.

Provider Business Mailing Address
First Line	:	1036 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-0971
Country	:	US
Telephone Number	:	212-794-2111
Fax Number	:	212-327-2296

Provider Business Practice Location Address
First Line	:	1036 PARK AVE
Second Line	:	SUITE 1B
City	:	NEW YORK
State	:	NY
Zip	:	10028-0971
Country	:	US
Telephone Number	:	212-794-2111
Fax Number	:	212-327-2296

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

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	10/23/2007

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