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Individual

CHARLES BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
90 S BEDFORD RD, MOUNT KISCO MEDICAL GROUP PC, MOUNT KISCO, NY 10549-3412
(914) 241-1050
(914) 242-1516
Mailing address
90 S BEDFORD RD, MOUNT KISCO MEDICAL GROUP PC, MOUNT KISCO, NY 10549-3412
(914) 241-1050
(914) 242-1516

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
110767
NY
207XP3100X
Pediatric Orthopaedic Surgery Physician
110767
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00245950
NY
01
0667910001
DME
NY
01
700002792
MEDICARE RAILROAD
NY
Enumeration date
05/19/2006
Last updated
05/15/2008
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