Dr Mack Functional & Family Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DR MACK FUNCTIONAL & FAMILY MEDICINE PC

Practice address

40 Route 46
Pine Brook, NJ 07058-9387

Phone

(914) 588-4454

NPI assigned

Aug 31, 2026

Last updated

Aug 31, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mack Lee Sullivan, MDNPI 1881616068

Title

Medical Director

Phone

(914) 395-3691

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mack Lee Sullivan, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Eastchester, NY
  • NPI 1881616068
  Authorized official Same address or phone

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1972411734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ROUTE 46",
            "city": "PINE BROOK",
            "state": "NJ",
            "postal_code": "070589387",
            "telephone_number": "914-588-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ROUTE 46",
            "city": "PINE BROOK",
            "state": "NJ",
            "postal_code": "070589387",
            "telephone_number": "914-588-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MACK FUNCTIONAL & FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MACK",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "914-395-3691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Counseling and Academic Services, LLC
• Gabrielle Darienzo
• Denise Ann Deluca, PSY.D.
• Jacqueline Anne Doddy, DNP, FNP-BC
• Stephanie Dorime, PHARMD
• Michal Dubowski, MD
• Paige Elizabeth Dwight Dickman, PT, DPT
• Mitchell L Elias, DDS
• Ursula Zienkiewicz Emas, PHARM.D.
• Empathic Journeys Counseling LLC

• Internal Medicine Physician in Pine Brook, NJ
• Providers in Pine Brook, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; 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.