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General NPI Number Information
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NPI Number | 1245127570
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Entity Type | Organization
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Legal Business Name | MICHAEL TOM MD PLLC
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 10/11/2025
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Provider Practice Location Address
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Address Line | 55 WASHINGTON ST STE 312B
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City | BROOKLYN
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State | NY
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Zip | 11201-1179
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Country | US
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Telephone | 718-218-5127
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Fax | 718-957-8734
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Provider Business Mailing Address
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Address Line | 418 BROADWAY STE N
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City | ALBANY
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State | NY
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Zip | 12207-2922
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Country | US
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Telephone |
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Fax | 718-957-8734
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL RYAN TOM
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Credential | MD
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Telephone | 718-218-5127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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