Individual
JENNY M.S. MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
161 CAREY RD, QUEENSBURY, NY 12804-7821
(518) 824-8610
(518) 824-2390
Mailing address
9 CAREY RD, QUEENSBURY, NY 12804-7880
(518) 761-0300
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310673
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07090760
—
NY
Enumeration date
02/17/2022
Last updated
03/30/2026
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