Individual
LISA BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
229 MILL RD, HOLBROOK, NY 11741-1020
(631) 588-0508
Mailing address
229 MILL RD, HOLBROOK, NY 11741-1020
(631) 588-0508
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
49392
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49392
SPECIAL EDUCATION TEACHER/EARLY INTERVENTION
—
05
—
49392
—
NY
01
—
49492
SPECIAL EDUCATION TEACHER/EARLY INTERVENTION
NY
Enumeration date
04/10/2014
Last updated
04/10/2014
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