Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Philip Tom, MD

Individual provider Dermatology Physician · NPI 1093724239

Jack Philip Tom, MD is a Dermatology Physician in Stony Brook, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

207 Hallock Rd Ste 211
Stony Brook, NY 11790-3033
Phone: (631) 444-0004
Fax: (631) 444-0088
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 155342 (NY)

Record details

NPI number1093724239
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 5, 2006
Last updated in NPPESJuly 8, 2007
Mailing address207 Hallock Rd, Suite 211, Stony Brook, NY 11790-3033

Other providers in Stony Brook