Provider Demographics
NPI:1619668795
Name:BROWN, COREY EDWARD
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:EDWARD
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 E TURKEYFOOT LAKE RD UNIT 632
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5306
Mailing Address - Country:US
Mailing Address - Phone:412-607-3803
Mailing Address - Fax:
Practice Address - Street 1:1541 E TURKEYFOOT LAKE RD UNIT 632
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5306
Practice Address - Country:US
Practice Address - Phone:412-607-3803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator