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NPI Code Detail

MEDICARE: SHEMINA BROOKS MSED

MEDICARE:   SHEMINA  BROOKS  MSED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistNY

General Provider Information

NPI Number : 1700148285
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEMINA BROOKS MSED
Provider Business Mailing Address
First Line : 24 MAXI CT
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10304-5201
Country : US
Telephone Number : 718-501-8996
Fax Number :
Provider Business Practice Location Address
First Line : 24 MAXI CT
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10304-5201
Country : US
Telephone Number : 718-501-8996
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2012
Last Update Date : 06/11/2012

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Directions to “ SHEMINA BROOKS MSED” Practice Location

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