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General NPI Number Information
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NPI Number | 1538568480
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Entity Type | Organization
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Legal Business Name | GERI BREWSTER RD MPH CDN PC
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Dates
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Enumeration Date | 08/16/2014
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Last Update Date | 08/16/2014
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Provider Practice Location Address
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Address Line | 491 LEXINGTON AVE FL 1
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City | MOUNT KISCO
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State | NY
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Zip | 10549-4307
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Country | US
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Telephone | 914-864-1976
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Fax | 914-864-1967
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Provider Business Mailing Address
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Address Line | 491 LEXINGTON AVE FL 1
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City | MOUNT KISCO
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State | NY
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Zip | 10549-4307
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Country | US
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Telephone | 914-864-1976
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Fax | 914-864-1967
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GERI BREWSTER
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Credential | RD MPH CDN
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Telephone | 914-864-1976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 8106819
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License Number State | NY
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