Provider Demographics
NPI:1174813547
Name:KILLIP, THOMAS III (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:KILLIP
Suffix:III
Gender:M
Credentials:MD
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:FIRST AVE & 16TH STREET
Mailing Address - Street 2:BETH ISRAEL MEDICAL CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3881
Mailing Address - Country:US
Mailing Address - Phone:212-420-4010
Mailing Address - Fax:212-420-4498
Practice Address - Street 1:FIRST AVE & 16TH STREET
Practice Address - Street 2:BETH ISRAEL MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3881
Practice Address - Country:US
Practice Address - Phone:212-420-4010
Practice Address - Fax:212-420-4498
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY074445207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease