Individual
MR. AINSWORTH O BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
13 CLEVELAND ST, VALLEY STREAM, NY 11580-6003
(516) 923-0793
Mailing address
10011 202ND ST, HOLLIS, NY 11423-3420
(646) 512-4005
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
304896
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
304896
LPN
NY
Enumeration date
04/21/2011
Last updated
04/21/2011
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