Ivan Mak

Athletic Trainer · Bayside, NY

Individual Active NPI

NPI number 1649870569

Practice location

22205 56TH Ave
Bayside, NY 11364-1432
Phone
(718) 281-5191

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NPI record

NPI
1649870569
Entity type
Individual (Type 1)
Enumeration date
October 29, 2020
Last updated
October 29, 2020
Certified
October 26, 2020
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X 002005-1 NY

Mailing address

222-19 B 69 Ave.
Oakland Gardens, NY 11364

About Ivan Mak

Ivan Mak is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 22205 56TH Ave, Bayside, NY 11364-1432. The NPI number 1649870569 was assigned on October 29, 2020 and the record was last updated on October 29, 2020.

Ivan Mak lists a license in the registry: #002005-1 (NY) for Athletic Trainer. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ivan Mak?

The NPI number is 1649870569.

What is the phone number of Ivan Mak?

The phone number listed for the practice location is (718) 281-5191.

Where is Ivan Mak located?

22205 56TH Ave, Bayside, NY 11364-1432.

What is the taxonomy code for Ivan Mak?

The primary taxonomy code is 2255A2300X – Athletic Trainer.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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