Provider Demographics
NPI:1528385747
Name:BROWN, SHELDON LEE (DPM, CPNP)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:LEE
Last Name:BROWN
Suffix:
Gender:M
Credentials:DPM, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 MAYBERRY PROMENADE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-6407
Mailing Address - Country:US
Mailing Address - Phone:718-581-7879
Mailing Address - Fax:
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:PEDIATRIC EMERGENCY DEPARTMENT
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1914
Practice Address - Country:US
Practice Address - Phone:201-996-5430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN-3895213ES0131X
NJ26NN07424400363LP0200X
NY307046363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery