Charles R Mack, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

293597-1 Issued in NY

Practice address

4185 Seneca St
Suite 11
West Seneca, NY 14224-3565

Phone

(716) 674-8189

Fax

(716) 712-0469

NPI assigned

Sep 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Andrew J. Siedlecki, M.D., PC

  dba Siedlecki Cataract and Vision Care

  • Ophthalmology Physician
  • Williamsville, NY
  • NPI 1689884488
  NPD (past)
• Niagara Frontier Anesthesia Services LLP

  • Certified Registered Nurse Anesthetist
  • West Seneca, NY
  • NPI 1962444505

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780786053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4185 SENECA STREET",
            "address_2": "SUITE 11",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "14224",
            "telephone_number": "716-674-8189",
            "fax_number": "716-712-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4185 SENECA ST",
            "address_2": "SUITE 11",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243565",
            "telephone_number": "716-674-8189",
            "fax_number": "716-712-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "CHARLES",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "293597-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Luderman, MP
• Nina Ludwig
• Melissa Ann Lukitsch, L.M.T., B.A.
• Victoria A Luongo
• Ivar Lupkin, CRC
• Kathryn Mackenzie
• Kristen Macneil, MA/CAS, BCBA
• Nicole Madden
• Michael F. Malachowski, OPHTHALMIC DISPENSER
• Audra Maliszewski

• Certified Registered Nurse Anesthetist in West Seneca, NY
• Providers in West Seneca, NY by specialty
• Certified Registered Nurse Anesthetist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.