Provider Demographics
NPI:1518055623
Name:BROWN, MARIA T (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:T
Last Name:BROWN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 PINE ST STE 210
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4948
Mailing Address - Country:US
Mailing Address - Phone:845-331-4484
Mailing Address - Fax:845-853-7106
Practice Address - Street 1:140 PINE ST STE 210
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4948
Practice Address - Country:US
Practice Address - Phone:845-331-4484
Practice Address - Fax:845-853-7106
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380094-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist