Provider Demographics
NPI:1053416941
Name:BROWN, PAMELA J (OD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3171 CHILI AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-5440
Mailing Address - Country:US
Mailing Address - Phone:585-889-9693
Mailing Address - Fax:585-889-3558
Practice Address - Street 1:3171 CHILI AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-5440
Practice Address - Country:US
Practice Address - Phone:585-889-9693
Practice Address - Fax:585-889-3558
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005201152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0837970001Medicare NSC
NYU19440Medicare UPIN
NYRA7482Medicare ID - Type Unspecified