Basic Information
| Provider Information | |||||||||
| NPI: | 1801892708 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 319 CENTRAL AVE STE B | ||||||||
| Address2: | |||||||||
| City: | DUNKIRK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140482137 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163636050 | ||||||||
| FaxNumber: | 7163636333 | ||||||||
| Practice Location | |||||||||
| Address1: | 107 INSTITUTE ST | ||||||||
| Address2: | |||||||||
| City: | JAMESTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147016628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7164844334 | ||||||||
| FaxNumber: | 7164844335 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2005 | ||||||||
| LastUpdateDate: | 08/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 213870 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01950834 | 05 | NY | MEDICAID |