Provider Demographics
NPI:1275848970
Name:BROWN, SAMUEL PEARCE (DO)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:PEARCE
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:635 BELLE TERRE RD STE 209
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1987
Mailing Address - Country:US
Mailing Address - Phone:631-474-0707
Mailing Address - Fax:631-828-6309
Practice Address - Street 1:635 BELLE TERRE RD STE 209
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1987
Practice Address - Country:US
Practice Address - Phone:631-474-0707
Practice Address - Fax:631-828-6309
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2797032081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine