Provider Demographics
NPI:1851408124
Name:BROOKS, EMILY S (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:S
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:C
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:80 HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:SANDS POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11050-2627
Mailing Address - Country:US
Mailing Address - Phone:516-496-3900
Mailing Address - Fax:516-496-9350
Practice Address - Street 1:79 FROEHLICH FARM BLVD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2903
Practice Address - Country:US
Practice Address - Phone:516-496-3900
Practice Address - Fax:516-496-9350
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184920207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY66H961Medicare ID - Type Unspecified
NYF58441Medicare UPIN