Provider Demographics
NPI:1003032467
Name:BROWN, HARRY J (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:J
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WHITE BIRCH ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883
Mailing Address - Country:US
Mailing Address - Phone:203-226-6670
Mailing Address - Fax:203-221-0554
Practice Address - Street 1:23 WHITE BIRCH ROAD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:CT
Practice Address - Zip Code:06883
Practice Address - Country:US
Practice Address - Phone:203-226-6670
Practice Address - Fax:203-221-0554
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010014958CT012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME14938OtherSTATE ID #
010014958CT01Medicare UPIN