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General NPI Number Information
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NPI Number | 1508930173
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Entity Type | Organization
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Legal Business Name | MAK HEALTHCARE, PC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 10/11/2017
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Provider Practice Location Address
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Address Line | 225 ERDMAN ST
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City | BANGOR
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State | PA
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Zip | 18013-2043
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Country | US
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Telephone | 610-588-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 225 ERDMAN ST
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City | BANGOR
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State | PA
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Zip | 18013-2043
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Country | US
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Telephone | 610-588-2225
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MAGDIEL GARCIA
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Credential | DC
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Telephone | 610-588-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State | PA
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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