Individual
MRS. IRIS MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
120 BETHPAGE RD, HICKSVILLE, NY 11801-1515
(631) 641-7851
(631) 430-2347
Mailing address
292 MARYLAND AVE, FREEPORT, NY 11520-1018
(917) 923-5562
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
992079
NY
Other
Enumeration date
08/01/2025
Last updated
08/01/2025
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