Provider Demographics
NPI:1144395617
Name:BROWN, PATRICIA JEFFRIES (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:JEFFRIES
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 CHANCELLOR AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-2285
Mailing Address - Country:US
Mailing Address - Phone:973-399-6292
Mailing Address - Fax:973-372-4534
Practice Address - Street 1:832 CHANCELLOR AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-2285
Practice Address - Country:US
Practice Address - Phone:973-399-6292
Practice Address - Fax:973-372-4534
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA43366207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1475207Medicaid
NJBR606225Medicare ID - Type Unspecified
NJ1475207Medicaid