Provider Demographics
NPI:1538203054
Name:BROWN, JENNIFER A (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:306 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-2011
Mailing Address - Country:US
Mailing Address - Phone:973-877-2580
Mailing Address - Fax:973-877-2578
Practice Address - Street 1:181 FRANKLIN AVE STE 303
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2900
Practice Address - Country:US
Practice Address - Phone:973-658-6315
Practice Address - Fax:973-352-7567
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB055986207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6409601Medicaid
NJ6409601Medicaid
NJ636106Medicare PIN