Provider Demographics
NPI:1922135300
Name:BROWN, ADAM D (PH, D)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:PH, D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 BEACON HILL DR
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2461
Mailing Address - Country:US
Mailing Address - Phone:914-714-2066
Mailing Address - Fax:
Practice Address - Street 1:143 BEACON HILL DR
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2461
Practice Address - Country:US
Practice Address - Phone:914-714-2066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01233401103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01233401OtherNYS LICENSE