Basic Information
Provider Information
NPI: 1598293607
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: JENNIFER
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 22581
Address2:  
City: NEW YORK
State: NY
PostalCode: 100872581
CountryCode: US
TelephoneNumber: 8566696050
FaxNumber: 8565283117
Practice Location
Address1: 1901 1ST AVENUE
Address2: METROPOLITAN HOSPITAL CENTER DEPT OF OBGYN
City: NEW YORK
State: NY
PostalCode: 10029
CountryCode: US
TelephoneNumber: 2124236796
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/02/2017
LastUpdateDate: 10/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X25MA11198400NJY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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