Individual
MS. ALVITA MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
47 HUMPHREY DR, SYOSSET, NY 11791-4022
(516) 921-7171
Mailing address
2386 BEDFORD AVE APT B, BELLMORE, NY 11710-3666
(516) 967-2168
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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