Basic Information
| Provider Information | |||||||||
| NPI: | 1174646988 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | BEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2800 MAIN ST | ||||||||
| Address2: | ST. VINCENT'S MEDICAL CENTER | ||||||||
| City: | BRIDGEPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066064201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035765711 | ||||||||
| FaxNumber: | 2035765022 | ||||||||
| Practice Location | |||||||||
| Address1: | 2800 MAIN ST | ||||||||
| Address2: | ST. VINCENT'S MEDICAL CENTER | ||||||||
| City: | BRIDGEPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066064201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035765711 | ||||||||
| FaxNumber: | 2035765022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2007 | ||||||||
| LastUpdateDate: | 11/11/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | 030178 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 030178 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207R00000X | 030178 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.