Individual
DR. JEREMIAH PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 FIRST AVENUE, NYU LANGONE MEDICAL CENTER, NEW YORK, NY 10016
(212) 263-5506
Mailing address
5901 E 7TH ST, LONG BEACH, CA 90822-5201
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
A148410
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2012
Last updated
01/30/2021
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