Provider Demographics
NPI:1851127534
Name:BROWN, ANTHONY II
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:BROWN
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 W 43RD ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2905
Mailing Address - Country:US
Mailing Address - Phone:440-222-8446
Mailing Address - Fax:
Practice Address - Street 1:1618 W 43RD ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-2905
Practice Address - Country:US
Practice Address - Phone:440-222-8446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker