Provider Demographics
NPI:1346328481
Name:WIERS, BROOK V (MD)
Entity Type:Individual
Prefix:
First Name:BROOK
Middle Name:V
Last Name:WIERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 MONTAGUE PL
Mailing Address - Street 2:#4
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2843
Mailing Address - Country:US
Mailing Address - Phone:781-383-6385
Mailing Address - Fax:
Practice Address - Street 1:83 MONTAGUE PL
Practice Address - Street 2:#4
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2843
Practice Address - Country:US
Practice Address - Phone:781-383-6385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204980207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology