Individual
INGRID BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
622 STOKES RD STE A, MEDFORD, NJ 08055-2913
(609) 953-0908
Mailing address
124 QUARRY ST UNIT 2C, PHILADELPHIA, PA 19106-2007
(215) 720-6501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA061479
PA
363AM0700X
Medical Physician Assistant
Primary
C5-0011726
DE
363AM0700X
Medical Physician Assistant
MA061479
PA
Other
Enumeration date
04/02/2020
Last updated
11/28/2022
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