Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 124025 | NY |
NPI | 1518921956 |
---|---|
Provider Name | William Ted Brown |
First Address | Staten Island, NY 10314 |
Second Address | Staten Island, NY 10314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 02/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01134041 | (05) | NY |
223700P | HIP (01) | NY |
2517073 | GHI (01) | NY |
359774 | UNITED HEALTHCARE (01) | NY |
4300010 | CIGNA (01) | NY |
7110906 | AETNA (01) | NY |
D46971 | (02) | NY |
P3654928 | OXFORD (01) | NY |