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General NPI Number Information
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NPI Number | 1225357387
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Entity Type | Organization
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Legal Business Name | WINSTON C. TOM MD PC
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Dates
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Enumeration Date | 05/27/2010
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 139 CENTRE ST SUITE 511
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City | NEW YORK
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State | NY
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Zip | 10013-4408
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Country | US
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Telephone | 212-941-8273
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Fax | 212-941-6033
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Provider Business Mailing Address
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Address Line | 139 CENTRE ST STE 511
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City | NEW YORK
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State | NY
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Zip | 10013-4408
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Country | US
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Telephone | 212-941-8273
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Fax | 212-941-6033
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WINSTON C TOM
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Credential | M.D
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Telephone | 212-941-8273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 159365
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License Number State | NY
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