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Individual

DR. ANYANATE GWENDOLYNE JACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D., MPH

Contact information

Practice address
211 E 80TH ST FL 2, NEW YORK, NY 10075
(646) 962-8690
Mailing address
525 E 68TH ST # 2026, NEW YORK, NY 10065-4870

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
2928521
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/08/2013
Last updated
07/17/2018
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