Individual
JEANNIE MAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
128 MOTT ST, SUITE 608, NEW YORK, NY 10013-5540
(212) 343-8399
Mailing address
3622 170TH ST, #3, FLUSHING, NY 11358-2204
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012951
NY
Other
Enumeration date
11/11/2008
Last updated
03/15/2012
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