Provider Demographics
NPI:1982872016
Name:BROWN, ANJEANETTE TINA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJEANETTE
Middle Name:TINA
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 ENGLISH CREEK AVE
Mailing Address - Street 2:BUILDING 800
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5549
Mailing Address - Country:US
Mailing Address - Phone:609-568-5606
Mailing Address - Fax:609-568-5877
Practice Address - Street 1:2500 ENGLISH CREEK AVE
Practice Address - Street 2:BUILDING 800
Practice Address - City:EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5549
Practice Address - Country:US
Practice Address - Phone:609-568-5606
Practice Address - Fax:609-568-5877
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07187300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA07187300OtherMEDICAL LICENSE