1407290083 NPI number — MRS. SHEREECE T BROWNE

Table of content: MRS. SHEREECE T BROWNE (NPI 1407290083)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407290083 NPI number — MRS. SHEREECE T BROWNE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWNE
Provider First Name:
SHEREECE
Provider Middle Name:
T
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BENT
Provider Other First Name:
SHEREECE
Provider Other Middle Name:
T
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407290083
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3198 GRAND CONCOURSE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10458-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-618-0401
Provider Business Mailing Address Fax Number:
718-795-4394

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2015 GRAND CONCOURSE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10453-4303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-299-7295
Provider Business Practice Location Address Fax Number:
718-299-6797
Provider Enumeration Date:
04/25/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  646173 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: AG0815057 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)