Individual
DR. JASON MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 1ST AVE, DEPT OF PEDIATRICS ROOM 523, NEW YORK, NY 10029-7404
(212) 423-6228
Mailing address
253 W 123RD ST, NEW YORK, NY 10027-5429
(212) 423-6228
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
178505
NY
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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