Provider Demographics
NPI:1073800165
Name:BROOKS, STEVEN JACOB (DO, FAOCD, MS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JACOB
Last Name:BROOKS
Suffix:
Gender:M
Credentials:DO, FAOCD, MS
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 COMMUNITY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3803
Mailing Address - Country:US
Mailing Address - Phone:516-439-4707
Mailing Address - Fax:
Practice Address - Street 1:444 COMMUNITY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3803
Practice Address - Country:US
Practice Address - Phone:516-439-4707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259565207NS0135X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology