Provider Demographics
NPI:1578892576
Name:KELLY-BROWN, MARGARET A
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:KELLY-BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:A
Other - Last Name:KELLY-BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACNP-BC
Mailing Address - Street 1:319 E 105TH ST
Mailing Address - Street 2:APT 5C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5032
Mailing Address - Country:US
Mailing Address - Phone:212-348-5412
Mailing Address - Fax:
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:MILSTEIN BUILDING, MICU-4HS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430360-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care