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General NPI Number Information
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NPI Number | 1659174399
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Entity Type | Individual
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Provider Name | NICOLE MAK
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Gender | Female
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 603 W 115TH ST # 231
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City | NEW YORK
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State | NY
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Zip | 10025-7722
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Country | US
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Telephone | --
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Fax |
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Provider Business Mailing Address
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Address Line | 603 W 115TH ST # 231
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City | NEW YORK
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State | NY
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Zip | 10025-7722
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NY
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