Provider Demographics
NPI:1447247937
Name:BROWNING, TRACEY JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:JEAN
Last Name:BROWNING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CHERRY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-1039
Mailing Address - Country:US
Mailing Address - Phone:413-746-8455
Mailing Address - Fax:
Practice Address - Street 1:373 PARK ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3304
Practice Address - Country:US
Practice Address - Phone:413-734-1001
Practice Address - Fax:413-736-4875
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215550208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2000474Medicaid