Individual
MICHAEL JASON TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RT
Contact information
Practice address
2510 30TH AVE, LONG ISLAND CITY, NY 11102-2418
(718) 267-4255
Mailing address
2510 30TH AVE, LONG ISLAND CITY, NY 11102-2418
(718) 267-4255
Taxonomy
Speciality
Code
Description
License number
State
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
Primary
012069
NY
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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