Provider Demographics
NPI:1811256258
Name:MAK, WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:MAK
Suffix:
Gender:
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:SUNY AT STONY BROOK DEPARTMENT OF PEDIATRICS
Mailing Address - Street 2:HSC T-11 / 040
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8111
Mailing Address - Country:US
Mailing Address - Phone:631-444-2020
Mailing Address - Fax:631-444-2894
Practice Address - Street 1:SUNY AT STONY BROOK DEPARTMENT OF PEDIATRICS
Practice Address - Street 2:HSC T-11 / 040
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8111
Practice Address - Country:US
Practice Address - Phone:631-444-2020
Practice Address - Fax:631-444-2894
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2025-03-06
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Provider Licenses
StateLicense IDTaxonomies
NY2796612080P0204X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics