1952576449 NPI number — MR. MARTIN EDWARD BROWN M.S., LMHC

Table of content: MR. MARTIN EDWARD BROWN M.S., LMHC (NPI 1952576449)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952576449 NPI number — MR. MARTIN EDWARD BROWN M.S., LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
MARTIN
Provider Middle Name:
EDWARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.S., LMHC
Provider Gender Code:
M

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:
1952576449
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 PRESIDENTIAL PLZ
Provider Second Line Business Mailing Address:
SUITE LL 05
Provider Business Mailing Address City Name:
SYRACUSE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13202-2229
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-308-0309
Provider Business Mailing Address Fax Number:
315-221-9504

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 PRESIDENTIAL PLZ
Provider Second Line Business Practice Location Address:
SUITE LL 05
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13202-2229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-308-0309
Provider Business Practice Location Address Fax Number:
315-221-9504
Provider Enumeration Date:
04/25/2008

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: 101YM0800X , with the licence number:  005284 , 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)





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