National Provider Identifier

Gary Ellis Brown

Gary Ellis Brown is listed in the NPPES registry with a primary specialty of Peer Specialist in Buffalo, NY and a listed phone number of (404) 456-5374.

NPI 1407503196Buffalo, NYPeer Specialist

Profile Overview

NPI
1407503196
Provider Type
Individual
Primary Specialty
Peer Specialist
Enumeration Date
March 03, 2022
Last Updated
March 03, 2022

Practice Location

  • 69 Linwood Ave
  • Buffalo, NY 14209-2203

Phone: (404) 456-5374

Specialties

  • Peer Specialist (175T00000X)
Full Record
NPI
1407503196
Entity Type
Individual
Last Name
Brown
First Name
Gary
Middle Name
Ellis
Mailing Street Address
69 Linwood Ave
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14209-2203
Mailing Country
US
Mailing Phone
(404) 456-5374
Practice Street Address
69 Linwood Ave
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14209-2203
Practice Country
US
Practice Phone
(404) 456-5374
Enumeration Date
March 03, 2022
Last Updated
March 03, 2022
Sex
Male
Sole Proprietor
No
Certification Date
March 03, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Peer Specialist (175T00000X)