National Provider Identifier
Jean Elizabeth Mack-Fogg
Jean Elizabeth Mack-Fogg is listed in the NPPES registry with a primary specialty of Pediatric Nurse Practitioner in Rochester, NY and a listed phone number of (585) 275-7787.
Profile Overview
- NPI
- 1023048600
- Provider Type
- Individual
- Primary Specialty
- Pediatric Nurse Practitioner
- Enumeration Date
- July 03, 2006
- Last Updated
- July 24, 2018
Practice Location
- 601 Elmwood Ave
- Rochester, NY 14642
Phone: (585) 275-7787
Mailing Address
- 601 Elmwood Ave
- Box 635
- Rochester, NY 14642-0001
Specialties
- Pediatric Nurse Practitioner (363LP0200X)
- Pediatric Nurse Practitioner (363LP0200X)
Full Record
- NPI
- 1023048600
- Entity Type
- Individual
- Last Name
- Mack-Fogg
- First Name
- Jean
- Middle Name
- Elizabeth
- Mailing Street Address
- 601 Elmwood Ave
- Mailing Address Line 2
- Box 635
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14642-0001
- Mailing Country
- US
- Mailing Phone
- (585) 275-7787
- Practice Street Address
- 601 Elmwood Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642
- Practice Country
- US
- Practice Phone
- (585) 275-7787
- Enumeration Date
- July 03, 2006
- Last Updated
- July 24, 2018
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Nurse Practitioner (363LP0200X), Pediatric Nurse Practitioner (363LP0200X)
- Other Identifiers
- 02299521 (NY)