Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 110767 | NY |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 110767 | NY |
NPI | 1679527402 |
---|---|
Provider Name | Charles Brown |
First Address | Mount Kisco, NY 10549-3412 |
Second Address | Mount Kisco, NY 10549-3412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 15/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00245950 | (05) | NY |
0667910001 | DME (01) | NY |
700002792 | MEDICARE RAILROAD (01) | NY |
D38330 | (02) | NY |