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General NPI Number Information
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NPI Number | 1609371442
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Entity Type | Individual
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Provider Name | MAX MACBARB MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 06/25/2021
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Provider Practice Location Address
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Address Line | 101 NICOLLS RD HSC LEVEL 4 -RM 080
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City | STONY BROOK
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State | NY
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Zip | 11974-0001
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Country | US
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Telephone | 631-444-3880
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Fax | 631-444-3919
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Provider Business Mailing Address
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Address Line | 39 HEDGES BANKS DR
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City | EAST HAMPTON
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State | NY
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Zip | 11937-3506
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 309411
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License Number State | NY
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