Basic Information
Provider Information
NPI: 1740593615
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: ASTIN
MiddleName: CATHERINE
NamePrefix:  
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 26911
Address2:  
City: NEW YORK
State: NY
PostalCode: 100876911
CountryCode: US
TelephoneNumber: 8004446020
FaxNumber: 8452561881
Practice Location
Address1: 1879 MADISON AVE
Address2:  
City: NEW YORK
State: NY
PostalCode: 100352709
CountryCode: US
TelephoneNumber: 2124234500
FaxNumber: 2124264577
Other Information
ProviderEnumerationDate: 07/21/2010
LastUpdateDate: 10/11/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X081675NYY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


Home