Individual provider · Type 1 NPI

Jonathan Erich Mackow, MD

Student in an Organized Health Care Education/Training Program · Southampton, NY

NPI number 1972298685 Active

Practice location

240 Meeting House Ln
Southampton, NY 11968-5009

Call (631) 726-0409 Map

Fax (631) 726-0396

Mailing address

101 Nicolls Rd
Stony Brook, NY 11794-5009

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1972298685

Jonathan Erich Mackow, MD's National Provider Identifier is 1972298685, issued on Apr 7, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Southampton, NY. The record was last updated on Jul 27, 2024.