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General NPI Number Information
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NPI Number | 1003315540
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Entity Type | Individual
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Provider Name | RACHEL LYNN BROOKS PTA
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Gender | Female
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Dates
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Enumeration Date | 02/11/2018
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Last Update Date | 02/11/2018
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Provider Practice Location Address
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Address Line | 299 E RIVER RD
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City | OSWEGO
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State | NY
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Zip | 13126-6400
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Country | US
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Telephone | 315-342-3166
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Fax |
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Provider Business Mailing Address
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Address Line | 8249 EASTWOOD RD
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City | CICERO
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State | NY
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Zip | 13039-9716
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Country | US
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Telephone | 315-317-0331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 010664-1
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License Number State | NY
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