Provider Demographics
NPI:1699272419
Name:BROWN, LUCY ANNE (MBA, RD, CDN)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:ANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MBA, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HARCOURT AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-4836
Mailing Address - Country:US
Mailing Address - Phone:908-319-6088
Mailing Address - Fax:
Practice Address - Street 1:17 E CARVER ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3409
Practice Address - Country:US
Practice Address - Phone:631-673-5433
Practice Address - Fax:631-673-5435
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered