Provider Demographics
NPI:1396206967
Name:BROWN, ELIZABETH ELEANOR (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ELEANOR
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4075
Mailing Address - Country:US
Mailing Address - Phone:203-705-0250
Mailing Address - Fax:203-705-0249
Practice Address - Street 1:195 DANBURY RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4075
Practice Address - Country:US
Practice Address - Phone:203-705-0250
Practice Address - Fax:203-705-0249
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125075414208100000X
CT79208208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation