Provider Demographics
NPI:1104663285
Name:BRAWN, ASHLEY RENEE (PT,DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:BRAWN
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CHARLESWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-2752
Mailing Address - Country:US
Mailing Address - Phone:585-721-6951
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE STE 400
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3092
Practice Address - Country:US
Practice Address - Phone:585-271-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05247401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist