Provider Demographics
NPI:1487857231
Name:BROWN BARONE, KATHLEEN MARY (DC OTR)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MARY
Last Name:BROWN BARONE
Suffix:
Gender:F
Credentials:DC OTR
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:200 ORCHARD ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5363
Mailing Address - Country:US
Mailing Address - Phone:203-777-2100
Mailing Address - Fax:203-777-5331
Practice Address - Street 1:200 ORCHARD ST
Practice Address - Street 2:SUITE 307
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5363
Practice Address - Country:US
Practice Address - Phone:203-777-2100
Practice Address - Fax:203-777-5331
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT626111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4081402Medicaid