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NPI Code Detail

MEDICARE: MR. STEVEN BROOKS R. PH.

MEDICARE: MR. STEVEN BROOKS R. PH.
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
1183500000XPharmacist28RI02594700NJ
2183500000XPharmacist032161NY

General Provider Information

NPI Number : 1295017390
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN BROOKS R. PH.
Provider Business Mailing Address
First Line : 11 OBERLIN CT
Second Line :
City : EDISON
State : NJ
Zip : 08820-1816
Country : US
Telephone Number : 908-668-8348
Fax Number :
Provider Business Practice Location Address
First Line : 110 MOUNTAIN BLVD EXT
Second Line :
City : WARREN
State : NJ
Zip : 07059-5633
Country : US
Telephone Number : 732-907-6745
Fax Number : 732-907-6747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2011
Last Update Date : 09/15/2011

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