Individual
EMILY MAUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
425 5TH AVE, BROOKLYN, NY 11215-4012
(718) 568-9220
Mailing address
143 W 4TH ST APT 5R, NEW YORK, NY 10012-1058
(804) 955-7675
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
383529
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383529
NEW YORK BOARD
NY
Enumeration date
02/20/2023
Last updated
02/20/2023
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