Provider Demographics
NPI:1326480096
Name:BROWN, MICHAEL L (COMPANION AIDE)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:COMPANION AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LONGHORN DR
Mailing Address - Street 2:
Mailing Address - City:WEST HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-9739
Mailing Address - Country:US
Mailing Address - Phone:585-353-5933
Mailing Address - Fax:
Practice Address - Street 1:24 LONGHORN DR
Practice Address - Street 2:
Practice Address - City:WEST HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14586-9739
Practice Address - Country:US
Practice Address - Phone:585-353-5933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion