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General NPI Number Information
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NPI Number | 1417152711
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Entity Type | Individual
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Provider Name | ANTONELLA BRUSCHI-BROOK DDS
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 175 MEMORIAL HWY STE 3-5
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5641
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Country | US
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Telephone | 914-235-2550
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Fax | 914-235-5102
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Provider Business Mailing Address
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Address Line | 49 WRIGHTS MILL RD
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City | ARMONK
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State | NY
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Zip | 10504-1137
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Country | US
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Telephone | 914-772-1614
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Fax | 914-235-5102
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 043919-1
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License Number State | NY
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