Provider Demographics
NPI:1164443032
Name:DOWNER, MARY BETH (PA)
Entity Type:Individual
Prefix:
First Name:MARY BETH
Middle Name:
Last Name:DOWNER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:77 LAFAYETTE PL
Mailing Address - Street 2:RADIATION ONCOLOGY-2ND FLOOR
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5426
Mailing Address - Country:US
Mailing Address - Phone:203-863-3773
Mailing Address - Fax:203-863-3723
Practice Address - Street 1:77 LAFAYETTE PL
Practice Address - Street 2:RADIATION ONCOLOGY-2ND FLOOR
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5426
Practice Address - Country:US
Practice Address - Phone:203-863-3773
Practice Address - Fax:203-863-3723
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT001167363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant