Basic Information
| Provider Information | |||||||||
| NPI: | 1134262736 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAIR | ||||||||
| FirstName: | BROOKE | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 515 MADISON AVE FL 6 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100225403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127526770 | ||||||||
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| Practice Location | |||||||||
| Address1: | 216 RTE 32 N | ||||||||
| Address2: | |||||||||
| City: | NEW PALTZ | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454195039 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 273364 | NY | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.