DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: DR. ETHAN ANDREW MACK MD, PHD

MEDICARE: DR. ETHAN ANDREW MACK MD, PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician334916NY

General Provider Information

NPI Number : 1922627843
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ETHAN ANDREW MACK MD, PHD
Provider Business Mailing Address
First Line : 180 FORT WASHINGTON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3722
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 622 W 168TH ST PH 1564W
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3720
Country : US
Telephone Number : 212-305-7399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2020
Last Update Date : 06/04/2026

Similar Medicare Providers

1508798000 — OONAGH FLORENCE KIRMAN PT, DPT
Practice Location Address:
622 W 168TH ST
NEW YORK, NY
10032-3720
Practice Phone: 646-299-1837
Practice Fax:
1013387471 — MARIOLINA BARTOLOMEO
Practice Location Address:
622 W 168TH ST
NEW YORK, NY
10032-3720
Practice Phone: 212-305-6204
Practice Fax: 212-342-1690
1710304159 — DR. BRITTANY KAITLIN WISE-ORINGER MD
Practice Location Address:
622 W 168TH ST PH 17W307
NEW YORK, NY
10032-3720
Practice Phone: 212-305-6559
Practice Fax: 212-305-4778
1811699135 — ANDREW MANAHAN
Practice Location Address:
622 W 168TH ST
NEW YORK, NY
10032-3720
Practice Phone: 212-305-6100
Practice Fax:
1811728520 — SAMUEL NATHAN SCHWARTZ
Practice Location Address:
622 W 168TH ST
NEW YORK, NY
10032-3720
Practice Phone: 201-781-2907
Practice Fax:
1508498965 — MRS. MADELINE MARY BEISEL
Practice Location Address:
622 W 168TH ST
NEW YORK, NY
10032-3720
Practice Phone: 443-878-4362
Practice Fax:

Directions to “ DR. ETHAN ANDREW MACK MD, PHD” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.