Basic Information
| Provider Information | |||||||||
| NPI: | 1992936942 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 535 E CRESCENT AVE | ||||||||
| Address2: | C/O HISTOPATHOLOGY SERVICES, LLC | ||||||||
| City: | RAMSEY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074462922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2016617280 | ||||||||
| FaxNumber: | 2016617297 | ||||||||
| Practice Location | |||||||||
| Address1: | 156 ROUTE 59, SUITE C6 | ||||||||
| Address2: | C/O HISTOPATHOLOGY SERVICES, LLC | ||||||||
| City: | SUFFERN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453694200 | ||||||||
| FaxNumber: | 2016617297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2009 | ||||||||
| LastUpdateDate: | 09/25/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | C53046 | CA | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | 207ZP0102X | 254768 | NY | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.