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General NPI Number Information
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NPI Number | 1942207980
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Entity Type | Individual
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Provider Name | ERIC R BROCKS MD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2005
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 200 WESTAGE BUSINESS CTR
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City | FISHKILL
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State | NY
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Zip | 12524-2264
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Country | US
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Telephone | 845-896-9280
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Fax | 845-896-0246
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Provider Business Mailing Address
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Address Line | 200 WESTAGE BUSINESS CTR
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City | FISHKILL
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State | NY
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Zip | 12524-2264
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Country | US
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Telephone | 845-896-9280
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Fax | 845-896-0246
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 116546
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License Number State | NY
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