Provider Demographics
NPI:1720340581
Name:RICHARDSON-BROWN, TOYE ROBERTA
Entity Type:Individual
Prefix:MRS
First Name:TOYE
Middle Name:ROBERTA
Last Name:RICHARDSON-BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TOYE
Other - Middle Name:ROBERTA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10411 200TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-1221
Mailing Address - Country:US
Mailing Address - Phone:718-413-5541
Mailing Address - Fax:626-605-8269
Practice Address - Street 1:10411 200TH ST
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-1221
Practice Address - Country:US
Practice Address - Phone:718-413-5541
Practice Address - Fax:626-605-8269
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY875376171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYTB457325OtherHPN ID