Mack, Joan Minette

Mack, Joan Minette is an individual health care provider with primary practice located at 1500 Lansdowne Ave , Darby PA 19023-1200. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is her primary health care specialty. Mack, Joan Minette can be contacted via phone (610) 237-4814.

Contact Information

Primary practice address
1500 Lansdowne Ave Darby PA 19023-1200
Phone: (610) 237-4814
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD030223E Pennsylvania
Allopathic & Osteopathic Physicians / General Practice 208D00000X MD 030223-E Pennsylvania

Profile Details

NPI number 1558309872
LBN Legal business name Mack, Joan Minette
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Aug 28th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558309872 NPPES
Pennsylvania MEDICAID 0012594240014

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