Healthcare Provider Details

I. General information

NPI: 1194545368
Provider Name (Legal Business Name): EMILY C TOM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 157
NEW YORK NY
10038
US

IV. Provider business mailing address

PO BOX 157
NEW YORK NY
10038
US

V. Phone/Fax

Practice location:
  • Phone: 917-373-8820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number072065
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: