Elizabeth Mack

Primary specialty

OpticianTaxonomy code 156FX1800X

License

1936 Issued in NH

Practice address

500 Gallery Blvd
Scarborough, ME 04074-6606

Phone

(207) 287-0160

NPI assigned

Sep 8, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Mack Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1720865397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SANBORN ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382229",
            "telephone_number": "207-651-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GALLERY BLVD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040746606",
            "telephone_number": "207-287-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NH",
            "license": "1936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MACK",
            "credential": "ABOC, NCLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ava Elizabeth Lowell, PT, DPT
• Christine Lu-Emerson, M.D.
• Emme Shea Macdonald, OTR/L
• Emily Corinne Mayberry Macduffie, MD
• Elizabeth Jane Macinnes, LMSW-CC, CADC
• Brooke K Maden, PA-C
• Christy L. Madore, NP-C
• Helia Maghzi, MD
• Christine Elizabeth Maguire, D.C.
• Stacy Anne Maguire, OTRL

• Optician in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Optician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.