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NPI Code Detail

MEDICARE: BROOKS COMENO

MEDICARE: BROOKS COMENO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist033205NY

General Provider Information

NPI Number : 1083904676
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKS COMENO
Provider Business Mailing Address
First Line : 318 SINGINGWOOD DR
Second Line :
City : HOLBROOK
State : NY
Zip : 11741-2829
Country : US
Telephone Number : 607-759-4035
Fax Number :
Provider Business Practice Location Address
First Line : 191 PATCHOGUE YAPHANK RD
Second Line :
City : EAST PATCHOGUE
State : NY
Zip : 11772-4899
Country : US
Telephone Number : 631-775-0971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2011
Last Update Date : 03/14/2022

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Directions to “ BROOKS COMENO ” Practice Location

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