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NPI Code Detail

MEDICARE: DR. PAUL JOSEPH BROOKE DC

MEDICARE: DR. PAUL JOSEPH BROOKE DC
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
1111NR0400XRehabilitation ChiropractorX3583NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1421629281OTHERNYTAX ID

General Provider Information

NPI Number : 1275749426
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL JOSEPH BROOKE DC
Provider Business Mailing Address
First Line : 270 E MAIN ST
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-8420
Country : US
Telephone Number : 631-666-6661
Fax Number : 631-666-0424
Provider Business Practice Location Address
First Line : 16 BRENTWOOD RD
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-8011
Country : US
Telephone Number : 631-666-6661
Fax Number : 631-666-0424
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 04/20/2011

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Directions to “ DR. PAUL JOSEPH BROOKE DC” Practice Location

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