Provider Demographics
NPI:1497234983
Name:BROWN, MELINDA SUSAN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:SUSAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:834 CHESTNUT ST APT 1014
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5141
Mailing Address - Country:US
Mailing Address - Phone:631-404-5198
Mailing Address - Fax:
Practice Address - Street 1:7600 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2442
Practice Address - Country:US
Practice Address - Phone:215-728-2276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant