1346221330 NPI number — ELIZABETH R BROWN MD

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	BROWN
Provider First Name	:	ELIZABETH
Provider Middle Name	:	R
Provider Name Prefix Text	:
Provider Name Suffix Text	:
Provider Credential Text	:	MD
Provider Gender Code	:	F

Provider Other Organization Name	:
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Provider Other First Name	:
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NPI Number	:	1346221330
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	07/08/2007
NPI Deactivation Reason Code	:
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Provider First Line Business Mailing Address	:	DIVISION OF PEDIATRICS DOWLING 3 SOUTH
Provider Second Line Business Mailing Address	:	ONE BOSTON MEDICAL CENTER PLACE
Provider Business Mailing Address City Name	:	BOSTON
Provider Business Mailing Address State Name	:	MA
Provider Business Mailing Address Postal Code	:	02118
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	6174145170
Provider Business Mailing Address Fax Number	:	6174143803

Provider First Line Business Practice Location Address	:	CHILD HEALTH FOUNDATION OF BOSTON
Provider Second Line Business Practice Location Address	:	DOWLING 3 SOUTH ONE BOSTON MEDICAL CENTER PLACE
Provider Business Practice Location Address City Name	:	BOSTON
Provider Business Practice Location Address State Name	:	MA
Provider Business Practice Location Address Postal Code	:	02118
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	6174142170
Provider Business Practice Location Address Fax Number	:	6174143803
Provider Enumeration Date	:	11/08/2005

Authorized Official Last Name	:
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• Taxonomy code: 208000000X , with the licence number:  39312 , registered in the state of MA .
• Taxonomy code: 2080N0001X , with the licence number: 39312 , registered in the state of MA .

• Identifier: E02010 . This identifiers is of the category "".
• Identifier: 2053349 , issued by the state of ( MA ) . This identifiers is of the category "".