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General NPI Number Information
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NPI Number | 1528768793
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Entity Type | Individual
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Provider Name | BROOKE THORNHILL
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Gender | Female
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 263 JERICHO TPKE
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City | FLORAL PARK
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State | NY
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Zip | 11001-2146
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Country | US
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Telephone | 516-365-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 4 REMSEN ST
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-4927
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Country | US
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Telephone | 631-316-2329
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2023
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License Number State | NY
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