Provider Demographics
NPI:1275507014
Name:BROWN, ROY EDWARD
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:EDWARD
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 E MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:COLDSPRING
Mailing Address - State:NC
Mailing Address - Zip Code:10516
Mailing Address - Country:US
Mailing Address - Phone:212-304-7250
Mailing Address - Fax:
Practice Address - Street 1:COLUMBIA UNIVERSITY DEPARTMENT PEDIATRICS
Practice Address - Street 2:3959 BROADWAY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-304-7297
Practice Address - Fax:212-544-1974
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY798091208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY52H951Medicare ID - Type Unspecified
NC01144912Medicare ID - Type Unspecified
NYD19795Medicare UPIN