Provider Demographics
NPI:1629400635
Name:BROOKS, JOEL P (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:P
Last Name:BROOKS
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3959 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1559
Mailing Address - Country:US
Mailing Address - Phone:212-305-2300
Mailing Address - Fax:212-305-4538
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:212-305-2300
Practice Address - Fax:212-305-4538
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3146642080P0201X
CT055048207R00000X
PAOT015311207R00000X
DCDO0348622080P0201X
MDH00881742080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine