Individual
MICHELLE MAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
512 KEARNY AVE STE B, KEARNY, NJ 07032-2703
(201) 998-7474
Mailing address
600 S 43RD ST, PHILADELPHIA, PA 19104-4418
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
NJ
Other
Enumeration date
07/17/2024
Last updated
01/15/2026
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