Healthcare Provider Details

I. General information

NPI: 1295542421
Provider Name (Legal Business Name): SHERMONTE BROOKS VI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 OLD ROUTE 7
BROOKFIELD CT
06804-1711
US

IV. Provider business mailing address

PO BOX 223
DANBURY CT
06813-0223
US

V. Phone/Fax

Practice location:
  • Phone: 203-740-9300
  • Fax:
Mailing address:
  • Phone: 682-999-1729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number6014217
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number896
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: