Individual
MR. JONATHAN M MAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1203 HIGH RIDGE RD, STAMFORD, CT 06905-1214
(203) 322-7669
Mailing address
1203 HIGH RIDGE RD, STAMFORD, CT 06905-1214
(203) 322-7669
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
28RI02832200
NJ
183500000X
Pharmacist
Primary
PCT.0010467
CT
Other
Enumeration date
12/03/2011
Last updated
12/03/2011
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