Provider Demographics
NPI:1023570892
Name:BROWN, DELONTE Z (NA)
Entity type:Individual
Prefix:MR
First Name:DELONTE
Middle Name:Z
Last Name:BROWN
Suffix:
Gender:M
Credentials:NA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20000
Mailing Address - Country:US
Mailing Address - Phone:202-655-1595
Mailing Address - Fax:
Practice Address - Street 1:12 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20000-2000
Practice Address - Country:US
Practice Address - Phone:202-655-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant