Provider Demographics
NPI:1700047008
Name:BROWN, NADINE CASSANDRA
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:CASSANDRA
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 7TH AVE
Mailing Address - Street 2:APT. 5H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030-1606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2430 7TH AVE
Practice Address - Street 2:APT. 5H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-1606
Practice Address - Country:US
Practice Address - Phone:646-406-2842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292732-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse