Individual
CHARLES MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
525 E 68TH ST, M404, NEW YORK, NY 10065-4870
(212) 746-5168
Mailing address
525 E 68TH ST, M404, NEW YORK, NY 10065-4870
(212) 746-5168
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
198115
NY
Other
Enumeration date
10/09/2006
Last updated
12/08/2022
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