Provider Demographics
NPI:1710015391
Name:BROWN, GLORIA MARGARITA (MSW)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:MARGARITA
Last Name:BROWN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1752
Mailing Address - Country:US
Mailing Address - Phone:646-205-1628
Mailing Address - Fax:
Practice Address - Street 1:1379 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1512
Practice Address - Country:US
Practice Address - Phone:646-205-1628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO297821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02197271 6Medicaid
NYNOJ461Medicare PIN