Provider Demographics
NPI:1528320462
Name:BROWN, ANNE THERESA (LAC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:THERESA
Last Name:BROWN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:26 E SHORE RD
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2025
Mailing Address - Country:US
Mailing Address - Phone:862-684-5677
Mailing Address - Fax:
Practice Address - Street 1:45 CAREY AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-1475
Practice Address - Country:US
Practice Address - Phone:862-684-5677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00055700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist