Individual
KATHERINE TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPCNP-BC
Contact information
Practice address
215 HEYWARD ST, BROOKLYN, NY 11206-2966
(718) 302-7900
Mailing address
564 1ST AVE APT 12G, NEW YORK, NY 10016-6484
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.447168
IL
363LP0200X
Pediatric Nurse Practitioner
209.014967
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
383024
NY
Other
Enumeration date
10/23/2016
Last updated
08/13/2021
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