Provider Demographics
NPI:1285254185
Name:BROOKS-OBAS, PAULA ROSE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ROSE
Last Name:BROOKS-OBAS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-7139
Mailing Address - Country:US
Mailing Address - Phone:516-412-5473
Mailing Address - Fax:516-710-7565
Practice Address - Street 1:166 BROWN AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-7139
Practice Address - Country:US
Practice Address - Phone:516-412-5473
Practice Address - Fax:516-710-7565
Is Sole Proprietor?:No
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY605046163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management