Provider Demographics
NPI:1538497003
Name:BROWN, PHILIP B (LAC)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:B
Last Name:BROWN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6384 MILL ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572
Mailing Address - Country:US
Mailing Address - Phone:845-943-7644
Mailing Address - Fax:
Practice Address - Street 1:6384 MILL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572
Practice Address - Country:US
Practice Address - Phone:845-943-7644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-21
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25-001524171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist