1659334746 NPI number — BROWN & ASSOCIATES SPORTS & ORTHOPAEDIC PHYSICAL THERAPY, P.A.

Table of content: (NPI 1659334746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659334746 NPI number — BROWN & ASSOCIATES SPORTS & ORTHOPAEDIC PHYSICAL THERAPY, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BROWN & ASSOCIATES SPORTS & ORTHOPAEDIC PHYSICAL THERAPY, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1659334746
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1288 S GOVERNORS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOVER
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19904-4802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-677-0100
Provider Business Mailing Address Fax Number:
302-677-0267

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1288 S GOVERNORS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOVER
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19904-4802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-677-0100
Provider Business Practice Location Address Fax Number:
302-677-0267
Provider Enumeration Date:
04/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
GLENN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
302-677-0100

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1991832261 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2251E1200X , with the licence number: 1991832261 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2251G0304X , with the licence number: 1991832261 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2251H1200X , with the licence number: 1991832261 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2251S0007X , with the licence number: 1991832261 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2251X0800X , with the licence number: 1991832261 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 216449 . This is a "MAMSI" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 460002 . This is a "AETNA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".