Provider Demographics
NPI:1972296747
Name:BROWNE, SHANE
Entity Type:Individual
Prefix:
First Name:SHANE
Middle Name:
Last Name:BROWNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHANE
Other - Middle Name:
Other - Last Name:TUCKER - BROWNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1434 STERLING PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-2909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1434 STERLING PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-2909
Practice Address - Country:US
Practice Address - Phone:917-749-7397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency