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General NPI Number Information
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NPI Number | 1255464707
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Entity Type | Individual
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Provider Name | FREDERICK R BROOKMAN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 157 E 18TH ST
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City | NEW YORK
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State | NY
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Zip | 10003-2409
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Country | US
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Telephone | 212-675-7591
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Fax | 212-675-7591
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Provider Business Mailing Address
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Address Line | 25 SUTTON PL S APT. 3C
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City | NEW YORK
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State | NY
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Zip | 10022-2441
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Country | US
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Telephone | 212-980-2787
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Fax | 212-675-7253
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | N005437
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License Number State | NY
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