Doctor Name: | MR. JERRY TOM |
NPI Number: | 1013378686 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 039314 |
Business Practice Address: | 11919 Graham Ct Flushing, NY - 113541047 |
Business Phone Number: | 7188880700 |
Business Fax Number: | |
Mailing Address: | 3520 97th St, Apt 9 CORONA |
State: | NY |
Postal Code: | 113681758 |
Phone Number: | 4049561585 |
Fax Number: | |
NPI Enumeration Date: | 03/10/2016 |
NPI Last Update Date: | 03/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 039314 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |