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1093724239
JACK PHILIP TOM
STONY BROOK, NY
NPI
1093724239
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207N00000X Dermatology
(Licence: NY 155342)
Enumeration Date
2006-08-05
Last Update Date
2007-07-08
Business Address
-- JACK PHILIP TOM M.D.
207 HALLOCK RD SUITE 211
STONY BROOK, NY 11790-3033
Phone number: 631-444-0004
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Mailing Address
-- JACK PHILIP TOM M.D.
207 HALLOCK RD SUITE 211
STONY BROOK, NY 11790-3033
Phone number: 631-444-0004
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