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General NPI Number Information
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NPI Number | 1841001914
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Entity Type | Individual
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Provider Name | BROOKS ROCK MSN, AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 260 LONG RIDGE RD
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City | STAMFORD
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State | CT
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Zip | 06902-1638
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Country | US
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Telephone | 475-240-5762
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Fax |
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Provider Business Mailing Address
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Address Line | 25 GLENBROOK RD APT 320
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City | STAMFORD
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State | CT
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Zip | 06902-2873
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Country | US
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Telephone | 469-352-4992
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 14372
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 140542
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License Number State | CT
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