Provider Demographics
NPI:1316005093
Name:BROWN, PATRICIA G (CNM)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:G
Last Name:BROWN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 MAIN ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:AVON BY THE SEA
Mailing Address - State:NJ
Mailing Address - Zip Code:07717-1051
Mailing Address - Country:US
Mailing Address - Phone:732-776-9790
Mailing Address - Fax:732-776-9793
Practice Address - Street 1:43 MAIN ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:AVON BY THE SEA
Practice Address - State:NJ
Practice Address - Zip Code:07717-1051
Practice Address - Country:US
Practice Address - Phone:732-776-9790
Practice Address - Fax:732-776-9793
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00032801367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJS71852Medicare UPIN
NJ023534UUGMedicare PIN