Provider Demographics
NPI:1801763040
Name:MACK, DEBORAH F
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:F
Last Name:MACK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 CARAVELLE DR # 14304
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-2729
Mailing Address - Country:US
Mailing Address - Phone:716-444-1811
Mailing Address - Fax:
Practice Address - Street 1:1667 CARAVELLE DR # 14304
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-2729
Practice Address - Country:US
Practice Address - Phone:716-444-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula