NPI Code Details Logo

NPI 1902798937

NPI 1902798937 : TRISTAN BROOKS : EAST ORANGE, NJ

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1902798937
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    TRISTAN BROOKS
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/15/2025
-----------------------------------------------------
    Last Update Date     |    01/06/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    175 PROSPECT ST 
-----------------------------------------------------
    City                 |    EAST ORANGE
-----------------------------------------------------
    State                |    NJ
-----------------------------------------------------
    Zip                  |    07017-2654
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    973-544-8334
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    6 BARRY DR 
-----------------------------------------------------
    City                 |    WEST ORANGE
-----------------------------------------------------
    State                |    NJ
-----------------------------------------------------
    Zip                  |    07052-3524
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    973-626-3056
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    1041C0700X
-----------------------------------------------------
    Taxonomy Name        |    Clinical Social Worker
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    NJ
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.