Dr. Edward J Mack
Geriatric Medicine
79 Middleville Road Chief Of Staff Office(11)
Northport
, New York 11768
Dr. Edward J Mack
Geriatric Medicine
79 Middleville Road Chief Of Staff Office(11)
Northport
, New York 11768
(631) 261-4400
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Edward J Mack
- 79 Middleville Road Northport Vamc, Chief Of Staff Office(11)
- Northport, NY
- Zip : 11768
- Phone : (631) 261-4400
Second Address
- Dr. Edward J Mack
- 79 Middleville Road Chief Of Staff Office(11)
- Northport, NY
- Zip : 11768
- Phone : (631) 261-4400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | 131445 | NY |
National Provider Identifier
| NPI | 1134148836 |
|---|---|
| Provider Name | Dr. Edward J Mack |
| First Address | Northport, NY 11768 |
| Second Address | Northport, NY 11768 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/07/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.