Individual
ALEXIS MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2 CAHILL ST, AMITYVILLE, NY 11701-1858
(631) 789-8525
(631) 789-4086
Mailing address
2 CAHILL ST, AMITYVILLE, NY 11701-1858
(631) 789-8525
(631) 789-4086
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
293904-1
NY
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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