Basic Information
| Provider Information | |||||||||
| NPI: | 1962657049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BROWN | ||||||||
| FirstName: | SYLVIA | ||||||||
| MiddleName: | ROSE | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1017 HANCOCK AVE | ||||||||
| Address2: | |||||||||
| City: | VANDERGRIFT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 156901615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242446047 | ||||||||
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| Practice Location | |||||||||
| Address1: | 885 MACBETH DR | ||||||||
| Address2: | |||||||||
| City: | MONROEVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151463332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128567071 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2008 | ||||||||
| LastUpdateDate: | 11/17/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | TE005748L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.