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General NPI Number Information
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NPI Number | 1003290776
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Entity Type | Organization
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Legal Business Name | BROOKS MEDICAL, P.C.
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 5014 BEVERLEY RD
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City | BROOKLYN
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State | NY
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Zip | 11203-5302
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Country | US
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Telephone | 718-241-0182
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Fax | 718-451-2517
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Provider Business Mailing Address
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Address Line | 5014 BEVERLEY RD
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City | BROOKLYN
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State | NY
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Zip | 11203-5302
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Country | US
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Telephone | 718-241-0182
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Fax | 718-451-2517
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LINDA BASTIEN
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Credential | M.D.
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Telephone | 718-241-0182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 229297
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License Number State | NY
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