1982872016 NPI number — DR. ANJEANETTE TINA BROWN MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982872016 NPI number — DR. ANJEANETTE TINA BROWN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
ANJEANETTE
Provider Middle Name:
TINA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982872016
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/25/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2500 ENGLISH CREEK AVE
Provider Second Line Business Mailing Address:
BUILDING 800
Provider Business Mailing Address City Name:
EGG HARBOR TWP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08234-5549
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-568-5606
Provider Business Mailing Address Fax Number:
609-568-5877

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 ENGLISH CREEK AVE
Provider Second Line Business Practice Location Address:
BUILDING 800
Provider Business Practice Location Address City Name:
EGG HARBOR TWP
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08234-5549
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-568-5606
Provider Business Practice Location Address Fax Number:
609-568-5877
Provider Enumeration Date:
02/12/2008

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: 208600000X , with the licence number:  MA07187300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: MA07187300 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".