Provider Demographics
NPI:1821220120
Name:BROWN, FLOS C (MD)
Entity Type:Individual
Prefix:
First Name:FLOS
Middle Name:C
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FLOS
Other - Middle Name:CARMELLI ILOGON
Other - Last Name:PIIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 LEROY ST
Mailing Address - Street 2:
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-1786
Mailing Address - Country:US
Mailing Address - Phone:315-265-3300
Mailing Address - Fax:315-261-6025
Practice Address - Street 1:35 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NY
Practice Address - Zip Code:13667-3129
Practice Address - Country:US
Practice Address - Phone:315-384-4881
Practice Address - Fax:315-384-4905
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY266983OtherNYS LICENSE