Provider Demographics
NPI:1437231701
Name:BROWN, ELAINE PATRICIA (MD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:PATRICIA
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1182 EAST 86 STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4737
Mailing Address - Country:US
Mailing Address - Phone:718-219-7680
Mailing Address - Fax:718-773-7470
Practice Address - Street 1:765 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-4203
Practice Address - Country:US
Practice Address - Phone:347-754-9967
Practice Address - Fax:718-773-7470
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233517207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02606191Medicaid
NY02606191Medicaid
NY614Y21Medicare ID - Type Unspecified