Provider Demographics
NPI:1811085962
Name:BROWN, MICHAEL S (MS,PT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1448
Mailing Address - Country:US
Mailing Address - Phone:516-505-2200
Mailing Address - Fax:516-505-5416
Practice Address - Street 1:300 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 3
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-1448
Practice Address - Country:US
Practice Address - Phone:516-505-2200
Practice Address - Fax:516-505-5416
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013585-2225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1838673OtherUNITED HEALTH CARE
NY1980625Medicaid
NY20562POtherHIP
NY3C0285OtherPHS
NY6699110OtherGHI
NYQ36381OtherEMPIRE BC/BS
NYP1052527OtherOXFORD HEALTH PLANS
NY3C0285OtherPHS
NYQ36381Medicare PIN