MARY ELLEN BROWN FNP NPI 1073794814

NPI Information

NPI: 1073794814
Provider Name: MARY ELLEN BROWN, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
2600 SOUTHPARK AVENUE
LACKAWANNA, NY
ZIP 14218
Phone: (716) 822-2028
Get Directions

Mary Ellen Brown, FNP is a family nurse practitioner in Lackawanna, NY. Mary Ellen Brown, FNP NPI is 1073794814. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2600 SOUTHPARK AVENUE
LACKAWANNA, NY
ZIP 14218-504
Phone: (716) 822-2028
Fax: (716) 822-2029

The NPI 1073794814 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/20/2007 and was last updated on 4/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	F335096-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9514408	OTHER	NEW YORK	INDEPENDENT HEALTH
2	00028208101	OTHER	NEW YORK	UNIVERA
3	A400147939	MEDICARE PIN	NEW YORK
4	000529830001	OTHER	NEW YORK	BLUE CROSS
5	01075516	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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