Provider Demographics
NPI:1639252828
Name:BROOKE, NORA S (MD)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:S
Last Name:BROOKE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:101 MAIN ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-4540
Mailing Address - Country:US
Mailing Address - Phone:781-396-1806
Mailing Address - Fax:781-396-5086
Practice Address - Street 1:101 MAIN ST
Practice Address - Street 2:SUITE 112
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4540
Practice Address - Country:US
Practice Address - Phone:781-396-1806
Practice Address - Fax:781-396-5086
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2229222084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I40009Medicare UPIN