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Organization
MACK DERMATOLOGY, P.C.
Active
Organization
MACK DERMATOLOGY, P.C.
Active
Other names
GlamDerm
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIAN A MACK M.D. (OWNER)
(917) 912-3615
Entity
Organization
Contact information
Practice address
130 E 18TH ST, SUITE 1U, NEW YORK, NY 10003-2416
(917) 912-3615
Mailing address
130 E 18TH ST, SUITE 1U, NEW YORK, NY 10003-2416
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
245368
NY
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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