Provider Demographics
NPI:1821647652
Name:BROOK, ANDREW (MS ED)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:BROOK
Suffix:
Gender:M
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HOLLYHOCK RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2423
Mailing Address - Country:US
Mailing Address - Phone:516-796-4232
Mailing Address - Fax:
Practice Address - Street 1:108 HOLLYHOCK RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-2423
Practice Address - Country:US
Practice Address - Phone:516-796-4232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool