Individual
DR. GREGORY IRVING MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
345 KEAR ST, SUITE 202, YORKTOWN HEIGHTS, NY 10598-4425
(845) 282-3367
(914) 743-1613
Mailing address
PO BOX 533, SHRUB OAK, NY 10588-0533
(845) 282-3367
(914) 743-1613
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
016597
NY
103TC0700X
Clinical Psychologist
Primary
016597
NY
103TF0000X
Family Psychologist
016597
NY
103TF0200X
Forensic Psychologist
016597
NY
103TP2701X
Group Psychotherapy Psychologist
016597
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03577942
—
NY
Enumeration date
01/12/2007
Last updated
02/25/2017
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