Individual
JOEL BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
479 SLEIGHT AVE, STATEN ISLAND, NY 10307-1942
(718) 605-5225
(718) 605-5225
Mailing address
479 SLEIGHT AVE, STATEN ISLAND, NY 10307-1942
(718) 605-5225
(718) 605-5225
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
119043
NY
Other
Enumeration date
09/23/2009
Last updated
09/23/2009
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