Provider Demographics
NPI:1467614057
Name:BROOKS, NNEKA OFFOR (MD)
Entity Type:Individual
Prefix:DR
First Name:NNEKA
Middle Name:OFFOR
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NNEKA
Other - Middle Name:L
Other - Last Name:OFFOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:52 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4266
Mailing Address - Country:US
Mailing Address - Phone:212-439-9600
Mailing Address - Fax:212-439-0796
Practice Address - Street 1:52 E 72ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4266
Practice Address - Country:US
Practice Address - Phone:212-439-9600
Practice Address - Fax:212-439-0796
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251370207W00000X
NY275024207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110093027AMedicaid
MA110093027AMedicaid