Provider Demographics
NPI:1710305024
Name:BROWN, ANDREW (RD, LDN, BS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:RD, LDN, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 DUCHESS CT
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1371
Mailing Address - Country:US
Mailing Address - Phone:610-256-9592
Mailing Address - Fax:
Practice Address - Street 1:1204 DUCHESS CT
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-1371
Practice Address - Country:US
Practice Address - Phone:610-256-9592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005092133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered