Individual
GLEN BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
80 MAIDEN LN, SUITE 703, NEW YORK, NY 10038-4811
(917) 261-7370
Mailing address
80 HARBOR ACRES RD, SANDS POINT, NY 11050-2627
(516) 662-1655
(212) 385-2434
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
156876
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00835552
—
NY
Enumeration date
06/27/2005
Last updated
01/13/2015
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