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Individual
MRS. ELEANOR MARIE MACK
Active
Individual
MRS. ELEANOR MARIE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
039801-I
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11-1556812C
—
NY
Enumeration date
11/15/2012
Last updated
11/15/2012
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