Individual
BRIGID MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
391 MYRTLE AVE STE 4A, ALBANY, NY 12208-3797
(518) 207-2273
(518) 207-2293
Mailing address
711 TROY SCHENECTADY RD, SUITE 203, LATHAM, NY 12110-2442
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
249141
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03015689
—
NY
Enumeration date
05/01/2007
Last updated
12/16/2019
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