National Provider Identifier

Marquita D Mack, L.P.N

Marquita D Mack, L.P.N is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Buffalo, NY and a listed phone number of (716) 894-5462.

NPI 1225279524Buffalo, NYLicensed Practical Nurse

Profile Overview

NPI
1225279524
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
March 16, 2009
Last Updated
March 16, 2009

Practice Location

  • 535 Stockbridge Ave
  • Buffalo, NY 14215-1707

Phone: (716) 894-5462

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1225279524
Entity Type
Individual
Last Name
Mack
First Name
Marquita
Middle Name
D
Name Prefix
MS.
Credential
L.P.N
Provider Other Last Name
Smith
Provider Other First Name
Marquita
Provider Other Name Prefix Text
Mrs.
Provider Other Credential Text
L.P.N
Provider Other Last Name Type Code
5
Mailing Street Address
535 Stockbridge Ave
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14215-1707
Mailing Country
US
Mailing Phone
(716) 510-6369
Practice Street Address
535 Stockbridge Ave
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14215-1707
Practice Country
US
Practice Phone
(716) 894-5462
Enumeration Date
March 16, 2009
Last Updated
March 16, 2009
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)