Provider Demographics
NPI:1386800464
Name:BROWN, ANDREW BENNETT (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BENNETT
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:55 W 26TH ST
Mailing Address - Street 2:APARTMENT 33G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1001
Mailing Address - Country:US
Mailing Address - Phone:917-922-1975
Mailing Address - Fax:
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:EAST WING, 2ND FLOOR
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5650
Practice Address - Fax:973-422-1653
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235696207RX0202X, 207R00000X, 207RH0000X
NJ25MA08932200207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03076148Medicaid
NYA400011996Medicare PIN