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1134148836
EDWARD J MACK
NORTHPORT, NY
NPI
1134148836
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RG0300X Internal Medicine, Geriatric Medicine
(Licence: NY 131445)
Enumeration Date
2006-07-19
Last Update Date
2007-07-08
Business Address
Dr. EDWARD J MACK MD
79 MIDDLEVILLE ROAD CHIEF OF STAFF OFFICE(11)
NORTHPORT, NY 11768
Phone number: 631-261-4400
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Mailing Address
Dr. EDWARD J MACK MD
79 MIDDLEVILLE ROAD NORTHPORT VAMC, CHIEF OF STAFF OFFICE(11)
NORTHPORT, NY 11768
Phone number: 631-261-4400
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