Provider Demographics
NPI:1942908090
Name:BROOKS, ROBERT MILO
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MILO
Last Name:BROOKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3003
Mailing Address - Country:US
Mailing Address - Phone:845-699-4847
Mailing Address - Fax:
Practice Address - Street 1:17 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3003
Practice Address - Country:US
Practice Address - Phone:845-699-4847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist