Provider Demographics
NPI:1457367104
Name:BROWN, JANET L (DO)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:824 MAIN STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2614
Mailing Address - Country:US
Mailing Address - Phone:610-935-7300
Mailing Address - Fax:610-917-0646
Practice Address - Street 1:701 MAIN ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-3823
Practice Address - Country:US
Practice Address - Phone:610-935-7300
Practice Address - Fax:610-933-8681
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS005370L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001159071Medicaid
PA001159071Medicaid
PA472325Medicare PIN