Healthcare Provider Details

I. General information

NPI: 1619782786
Provider Name (Legal Business Name): DAGERIA ANTOINETTE BROOKS, NP IN PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 NEW KARNER RD
ALBANY NY
12205-3854
US

IV. Provider business mailing address

12 PRESERVE WAY
SCHENECTADY NY
12304-8510
US

V. Phone/Fax

Practice location:
  • Phone: 516-851-2961
  • Fax: 888-687-7273
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAGERIA BROOKS
Title or Position: FOUNDER
Credential: NP
Phone: 203-998-6673