Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080A0000X | Adolescent Medicine | OS009933L | PA |
Y | 208D00000X | General Practice Physician | OS009933L | PA |
NPI | 1285690537 |
---|---|
Provider Name | Dr. Meghan Mary Brooks |
First Address | Rockland, DE 19732-0191 |
Second Address | Glen Mills, PA 19342-8182 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 10/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0019066990001 | (05) | PA |