Provider Demographics
NPI:1629242664
Name:BROWN, BARRY L (PT)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:19737 LEITERSBURG PIKE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-1508
Mailing Address - Country:US
Mailing Address - Phone:240-420-0859
Mailing Address - Fax:240-420-0971
Practice Address - Street 1:188 EASTERN BLVD N
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5843
Practice Address - Country:US
Practice Address - Phone:301-714-0700
Practice Address - Fax:301-714-0700
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD15892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD690700800Medicaid
MD216610Medicare Oscar/Certification