Healthcare Provider Details

I. General information

NPI: 1457046054
Provider Name (Legal Business Name): BROCHA BROOKS KARP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BROCHA BROOKS MD

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E KENNEDY BLVD STE 1
LAKEWOOD NJ
08701-1488
US

IV. Provider business mailing address

450 E KENNEDY BLVD STE 1
LAKEWOOD NJ
08701-1488
US

V. Phone/Fax

Practice location:
  • Phone: 732-901-0050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA13310900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: