Provider Demographics
NPI:1215346101
Name:BROWN, MEGHAN ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:BROWN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4679 FAIRBANKS DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13215-9500
Mailing Address - Country:US
Mailing Address - Phone:315-440-0472
Mailing Address - Fax:
Practice Address - Street 1:235 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5962
Practice Address - Country:US
Practice Address - Phone:518-587-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist