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1780786053
CHARLES R MACK
WEST SENECA, NY
NPI
1780786053
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: NY 293597-1)
Enumeration Date
2006-09-05
Last Update Date
2007-07-08
Business Address
CHARLES R MACK CRNA
4185 SENECA ST SUITE 11
WEST SENECA, NY 14224-3565
Phone number: 716-674-8189
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Mailing Address
CHARLES R MACK CRNA
4185 SENECA STREET SUITE 11
WEST SENECA, NY 14224
Phone number: 716-674-8189
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