Provider Demographics
NPI:1740861855
Name:SAMUEL BROWN DO, PC
Entity type:Organization
Organization Name:SAMUEL BROWN DO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-476-4000
Mailing Address - Street 1:3 FRANCES LN
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1125
Mailing Address - Country:US
Mailing Address - Phone:631-476-4000
Mailing Address - Fax:631-629-1077
Practice Address - Street 1:3 FRANCES LN
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1125
Practice Address - Country:US
Practice Address - Phone:631-476-4000
Practice Address - Fax:631-629-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty