Provider Demographics
NPI:1326113390
Name:TOW, TONY W Y (MD)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:W Y
Last Name:TOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 E MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8415
Mailing Address - Country:US
Mailing Address - Phone:631-666-5864
Mailing Address - Fax:631-666-1187
Practice Address - Street 1:370 EAST MAIN STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-666-5806
Practice Address - Fax:631-666-1187
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142629207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00986714Medicaid
NY25D681Medicare ID - Type Unspecified
NY00986714Medicaid