Provider Demographics
NPI:1972519015
Name:MOSKOWITZ-BROOKS, NAOMI P (MD)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:P
Last Name:MOSKOWITZ-BROOKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:P
Other - Last Name:MOSKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 611
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3808
Mailing Address - Country:US
Mailing Address - Phone:516-663-2532
Mailing Address - Fax:516-663-2233
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 460
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4064
Practice Address - Country:US
Practice Address - Phone:516-663-9400
Practice Address - Fax:516-663-9482
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2260882080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02785179Medicaid