Provider Demographics
NPI:1144218256
Name:BROWN, ALAN CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:CHARLES
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:205 W END AVE
Mailing Address - Street 2:STE 1P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4804
Mailing Address - Country:US
Mailing Address - Phone:212-724-4430
Mailing Address - Fax:212-724-6938
Practice Address - Street 1:205 W END AVE
Practice Address - Street 2:STE 1P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4804
Practice Address - Country:US
Practice Address - Phone:212-724-4430
Practice Address - Fax:212-724-6938
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY134669207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00774947Medicaid
91A821Medicare ID - Type Unspecified
NY00774947Medicaid