Individual
AVRAM MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(215) 590-7555
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104
(215) 590-7555
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
35487
DC
2084P0800X
Psychiatry Physician
Primary
MD456188
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00706932
RAILROAD MEDICARE
DC
Enumeration date
12/14/2005
Last updated
03/03/2016
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