Provider Demographics
NPI:1841389889
Name:BROWN, DONNA M (DC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-2830
Mailing Address - Country:US
Mailing Address - Phone:631-893-3490
Mailing Address - Fax:631-893-3492
Practice Address - Street 1:157 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2830
Practice Address - Country:US
Practice Address - Phone:631-893-3490
Practice Address - Fax:631-893-3492
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX23162Medicare ID - Type Unspecified