Provider Demographics
NPI:1396823589
Name:BROWN, JASON W (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:W
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1542 COLUMBIA TPKE
Mailing Address - Street 2:
Mailing Address - City:CASTLETON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-9545
Mailing Address - Country:US
Mailing Address - Phone:518-477-4405
Mailing Address - Fax:518-477-2216
Practice Address - Street 1:81 MILLER RD
Practice Address - Street 2:SUITE 600
Practice Address - City:CASTLETON
Practice Address - State:NY
Practice Address - Zip Code:12033-4022
Practice Address - Country:US
Practice Address - Phone:518-213-0394
Practice Address - Fax:518-479-0269
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYX011329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB3386Medicare PIN