Provider Demographics
NPI:1194139717
Name:BROWN, KEVIN JAMES (DPT)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:JAMES
Last Name:BROWN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7687 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-8742
Mailing Address - Country:US
Mailing Address - Phone:315-218-1451
Mailing Address - Fax:315-458-2975
Practice Address - Street 1:19 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-2501
Practice Address - Country:US
Practice Address - Phone:315-635-5000
Practice Address - Fax:315-635-3663
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist