Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 010664-1 | NY |
NPI | 1003315540 |
---|---|
Provider Name | Rachel Lynn Brooks |
First Address | Cicero, NY 13039-9716 |
Second Address | Oswego, NY 13126-6400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2018 |
Last Update Date | 11/02/2018 |