Provider Demographics
NPI:1003091950
Name:THOURYA HAOUES-BROWN MD LLC
Entity Type:Organization
Organization Name:THOURYA HAOUES-BROWN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOURYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAOUES-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:230-740-9099
Mailing Address - Street 1:246 FEDERAL RD
Mailing Address - Street 2:UNIT C32
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2647
Mailing Address - Country:US
Mailing Address - Phone:203-740-9099
Mailing Address - Fax:203-740-9097
Practice Address - Street 1:246 FEDERAL RD
Practice Address - Street 2:UNIT C32
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2647
Practice Address - Country:US
Practice Address - Phone:203-740-9099
Practice Address - Fax:203-740-9097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTH08808Medicare UPIN