Provider Demographics
NPI:1245946300
Name:BROOKS, MARTIN HILL (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:HILL
Last Name:BROOKS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MARTIN
Other - Middle Name:HILL
Other - Last Name:SCHMATOLLA-BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1260 LEHIGH STATION RD APT 1006
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9248
Mailing Address - Country:US
Mailing Address - Phone:585-748-3132
Mailing Address - Fax:
Practice Address - Street 1:1260 LEHIGH STATION RD APT 1006
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9248
Practice Address - Country:US
Practice Address - Phone:585-748-3132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025425-01103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist