Provider Demographics
NPI:1932421781
Name:BROWN, STEPHENNE ANN (PHARMD, RD/CDN)
Entity Type:Individual
Prefix:DR
First Name:STEPHENNE
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARMD, RD/CDN
Other - Prefix:
Other - First Name:STEPHENNE
Other - Middle Name:BROWN
Other - Last Name:MCFADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RD/CDN
Mailing Address - Street 1:1850 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIE
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 CRANSTON RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-7219
Practice Address - Country:US
Practice Address - Phone:518-271-0081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052594183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist