Provider Demographics
NPI:1669754123
Name:HEYSE, THOMAS JAN (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JAN
Last Name:HEYSE
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 1:520E 72ND STREET
Mailing Address - Street 2:14C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:917-421-9308
Mailing Address - Fax:
Practice Address - Street 1:535 EAST 70TH STREET
Practice Address - Street 2:HOSPITAL FOR SPECIAL SURGERY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-774-2302
Practice Address - Fax:212-606-1477
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program