Provider Demographics
NPI:1811214539
Name:BRAWE, PATRICIA ANN (LAC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:BRAWE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 WEST 29TH STREET
Mailing Address - Street 2:SUITE 901
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5684
Mailing Address - Country:US
Mailing Address - Phone:646-573-1717
Mailing Address - Fax:
Practice Address - Street 1:214 WEST 29TH STREET
Practice Address - Street 2:SUITE 901
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5684
Practice Address - Country:US
Practice Address - Phone:646-573-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004313-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist