Jack Philip Tom, M.D.

NPI #1093724239 in Stony Brook, New York

Provider Information

NPI Number: 1093724239
Entity Type: Individual
Name: Jack Philip Tom, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dermatology
Credential: M.D.
Enumeration Date: Aug 5, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 207 HALLOCK RD
Address 2: SUITE 211
City: Stony Brook
State: New York
ZIP Code: 11790-3033
Phone: (631) 444-0004

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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