Individual
GLORIA PATRICIA MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NDTR
Contact information
Practice address
130 W KINGSBRIDGE RD, BRONX, NY 10468-3904
(718) 584-9000
Mailing address
225 DR MARTIN LUTHER KING BLVD APT 7E, WHITE PLAINS, NY 10601-4125
(914) 263-1860
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
—
—
Other
Enumeration date
02/24/2025
Last updated
02/24/2025
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