Provider Demographics
NPI:1700248168
Name:CASTRO-BROWN, AMY COVINGTON (DO)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:COVINGTON
Last Name:CASTRO-BROWN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:COVINGTON
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:61 BUTLER DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7245
Mailing Address - Country:US
Mailing Address - Phone:802-242-0225
Mailing Address - Fax:
Practice Address - Street 1:61 BUTLER DR
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7245
Practice Address - Country:US
Practice Address - Phone:802-242-0225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT031-01196092084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program