# THOMAS F. JAN D.O., PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639402092
- **Authorized official:** DR. THOMAS F. JAN D.O (PRESIDENT)
- **Authorized official phone:** (516) 541-1064

## Contact information

- **Practice address:** 4200 SUNRISE HWY, MASSAPEQUA, NY 11758-5311
- **Practice address phone:** (516) 541-1064
- **Practice address fax:** (516) 798-9070
- **Mailing address:** 4200 SUNRISE HWY, MASSAPEQUA, NY 11758-5311
- **Mailing address phone:** (516) 541-1064
- **Mailing address fax:** (516) 798-9070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 204322-1 | NY | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 204322-1 | NY | — |

## Other

- **Enumeration date:** 09/16/2009
- **Last updated:** 09/16/2009