Provider Demographics
NPI:1356744734
Name:KEARN, THOMAS JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:KEARN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 TROY PL
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3814
Mailing Address - Country:US
Mailing Address - Phone:516-849-0818
Mailing Address - Fax:
Practice Address - Street 1:100 WILLIAM ST
Practice Address - Street 2:1215
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4512
Practice Address - Country:US
Practice Address - Phone:212-509-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor