Individual provider · Type 1 NPI

Ilaisiah Brooks, LPN

Licensed Practical Nurse · Mastic Beach, NY

NPI number 1417804667 Active

Practice location

111 Church Dr
Mastic Beach, NY 11951-1801

Call (631) 504-2618 Map

Fax (631) 504-2618

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X355878 (NY)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1417804667

Ilaisiah Brooks, LPN's National Provider Identifier is 1417804667, issued on Mar 16, 2026. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Mastic Beach, NY. The record was last updated on Mar 16, 2026.