Provider Demographics
NPI:1700935715
Name:BROCKNER, NORA (MD)
Entity type:Individual
Prefix:DR
First Name:NORA
Middle Name:
Last Name:BROCKNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:BROCKNER BROWER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:124 EAST 84 STREET
Mailing Address - Street 2:#1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:212-772-9732
Mailing Address - Fax:
Practice Address - Street 1:124 EAST 84 STREET
Practice Address - Street 2:#1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:212-772-9732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1282372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A98556Medicare UPIN
06A901Medicare ID - Type Unspecified