Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 17771 | CT |
NPI | 1437149416 |
---|---|
Provider Name | Dr. Lionel Graham Brown |
First Address | Danbury, CT 06811-4959 |
Second Address | Danbury, CT 06811-4959 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 29/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17771 | STATE LICENSE (01) | CT |