JACK PHILIP TOM (NPI# 1093724239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093724239 |
Entity Type | Individual |
Full Name | JACK PHILIP TOM |
Credential | M.D. |
Practice Address |
207 Hallock Rd Suite 211 Stony Brook NY 11790-3033 |
Practice Telephone | 6314440004 |
Practice Fax Number | 6314440088 |
Mailing Telephone | 6314440004 |
Mailing Fax Number | 6314440088 |
Enumeration Date | 2006-08-05 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | 155342 | NY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 01711760 | 05 |
Street Address |
207 HALLOCK RD SUITE 211 |
City | STONY BROOK |
State | NY |
Zip Code | 11790-3033 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851361414 | Peter Smith | Podiatrist | 207 Hallock Rd, Suite 4, Stony Brook, NY 11790-3033 | 2006-01-25 |
1720646805 | Samantha Lynn Renieris | Speech-Language Pathologist | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2019-06-03 |
1518451459 | Jessica Liberty | Speech-Language Pathologist | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2018-06-14 |
1922501964 | Melissa M Schachter | Speech-Language Pathologist | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2018-03-15 |
1891217774 | Marisa Massaro | Family Medicine | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2017-07-12 |
1497289037 | Stony Brook Oral and Facial Surgery PC | Dentist | 207 Hallock Rd, Suite 2, Stony Brook, NY 11790-3033 | 2017-04-19 |
1306394978 | Doughty and Ryzova Medical Group PC | Pediatrics | 207 Hallock Rd, Suite 106, Stony Brook, NY 11790-3033 | 2016-09-13 |
1376099226 | Mireille Toughey | Registered Nurse | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2016-08-31 |
1518360197 | Marianne Kaminski | Registered Nurse | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2014-09-26 |
1962803163 | Dianne Munnich | Registered Nurse | 207 Hallock Rd, Stony Brook, NY 11790-3033 | 2014-09-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
Find all providers in zip 11790 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023062973 | Joann N Salvemini | Dermatology | 1320 Stony Brook Rd Ste 200, Stony Brook, NY 11790 | 2006-05-22 |
1265434682 | James Joseph Briley Jr. | Dermatology | 1320 Stony Brook Rd Bldg F2nd, Stony Brook, NY 11790-2206 | 2005-08-15 |
1699025635 | Elyse S Rafal M D P C | Dermatology | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2012-09-18 |
1841396546 | Amy Wishner Steinberg | Dermatology | 2500 Route 347, Bldg 5a Amy Wishner Steinberg Md, Stony Brook, NY 11790-2555 | 2006-09-16 |
1497700819 | Stony Brook Dermatology Associates, University Faculty Practice Corpor | Dermatology | Suny @ Stony Brook, Hsc, L16, Rm 060, Stony Brook, NY 11794-0001 | 2006-05-24 |
1477515781 | Elyse S. Rafal | Dermatology | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2006-04-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225636384 | Markowitz Medical Pllc | Dermatology | 1150 5th Ave # Suire1a, New York, NY 10128-0724 | 2020-10-12 |
1114545985 | Tarek Yamany Md Pllc | Dermatology | 229 W 60th St Apt 8e, New York, NY 10023-7507 | 2020-07-08 |
1952924839 | Elizabeth Jessica Ranelli | Dermatology | 16 W 17th St, New York, NY 10011-5738 | 2020-05-26 |
1841811148 | Stuart Daniel Shanler | Dermatology | 53 Underhill Dr, Pomona, NY 10970-2668 | 2020-04-28 |
1740800309 | Ns Arora Dermatology Pllc | Dermatology | 99 Jericho Tpke Ste 110, Jericho, NY 11753-1015 | 2020-04-23 |
1174163406 | Halite Services Crop | Dermatology | 447 Rose Ln, Rockville Centre, NY 11570-1429 | 2020-01-15 |
1235776485 | Libby Rhee Do Dermatology Pllc | Dermatology | 110 E 60th St # 800, New York, NY 10022-1688 | 2019-12-06 |
1588214357 | Advanced Dermatology of New York PC | Dermatology | 1-3 West 125th Street, New York, NY 10027 | 2019-09-13 |
1568018588 | Mary Matina Valinotti | Dermatology | 332 E Main St Ste 1, Bay Shore, NY 11706-8436 | 2019-08-15 |
1831751379 | Jessica Weiser, M.d., Pllc | Dermatology | 155 Spring St Fl 5, New York, NY 10012-5208 | 2019-07-05 |
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City | STONY BROOK |
Zip Code | 11790 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.