Provider Demographics
NPI:1164297669
Name:BROWN, DARLENE LINDA
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:LINDA
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DARLENE
Other - Middle Name:LINDA
Other - Last Name:REISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13 GALLOWAY HTS
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1813
Mailing Address - Country:US
Mailing Address - Phone:845-324-5645
Mailing Address - Fax:
Practice Address - Street 1:13 GALLOWAY HTS
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1813
Practice Address - Country:US
Practice Address - Phone:845-324-5645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP125856225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist