Provider Demographics
NPI:1669519872
Name:FASY, THOMAS M (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:FASY
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Gender:M
Credentials:MD, PHD
Other - Prefix:
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Mailing Address - Street 1:110 WEST 86TH ST.
Mailing Address - Street 2:11C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4060
Mailing Address - Country:US
Mailing Address - Phone:212-241-9155
Mailing Address - Fax:212-289-2899
Practice Address - Street 1:MOUNT SINAI SCHOOL OF MEDICINE BOX 1194
Practice Address - Street 2:ONE GUSTAVE LEVY PLACE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-9155
Practice Address - Fax:212-289-2899
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY139492207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology