Individual
JEFFREY HOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 NICHOLLS ROAD, STONY BROOK UNIVERSITY MEDICAL CENTER, STONY BROOK, NY 11790-0001
(631) 444-0650
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-0650
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
210776
NY
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
210776
NY
Other
Enumeration date
08/22/2005
Last updated
05/26/2015
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