Provider Demographics
NPI:1972946838
Name:BROWN, CARLENE D (HIS)
Entity Type:Individual
Prefix:
First Name:CARLENE
Middle Name:D
Last Name:BROWN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 WARREN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-3016
Mailing Address - Country:US
Mailing Address - Phone:518-828-9902
Mailing Address - Fax:518-282-7419
Practice Address - Street 1:751 WARREN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-3016
Practice Address - Country:US
Practice Address - Phone:518-828-9902
Practice Address - Fax:518-282-7419
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000036698237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist