Provider Demographics
NPI:1659455780
Name:BROWN, MICHAEL R (PT, DPT, PHD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:R
Last Name:BROWN
Suffix:
Gender:M
Credentials:PT, DPT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 SWEET HOME RD STE 1-02
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2329
Mailing Address - Country:US
Mailing Address - Phone:716-525-1184
Mailing Address - Fax:716-243-4721
Practice Address - Street 1:2360 SWEET HOME RD STE 1-02
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2329
Practice Address - Country:US
Practice Address - Phone:716-525-1184
Practice Address - Fax:716-243-4721
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000928552001OtherHEALTH NOW NY
NY7832744OtherAETNA
NY174134FTOtherPREFERRED CARE
NY7832744OtherAETNA