MRS. Ilene Mack

NPI #1013778489 in Middle Island, New York

Provider Information

NPI Number: 1013778489
Entity Type: Individual
Name: MRS. Ilene Mack
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dietitian, Registered
Enumeration Date: Jan 22, 2024
Last Updated: Jan 22, 2024

Practice Location

Address: 49 OAKCREST AVE
City: Middle Island
State: New York
ZIP Code: 11953-1415
Phone: (516) 697-7383

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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