DJOSER MACK NPI 1629655592

NPI Information

  • NPI: 1629655592
  • Provider Name: DJOSER MACK
  • Classification: Emergency Medicine - 207P00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1 HOSPITAL PLZ
    STAMFORD, CT
    ZIP 06902
  • Phone: (203) 276-7777

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NPI Details

Djoser Mack is an emergency medicine in Stamford, CT with 5 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. Djoser Mack NPI is 1629655592. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NEW YORK MEDICAL COLLEGE
Graduation Year:2021

The provider's business location address is:

1 HOSPITAL PLZ
STAMFORD, CT
ZIP 06902-602
Phone: (203) 276-7777

The NPI 1629655592 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/26/2021 and was last updated on 6/24/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2207P00000XEmergency Medicine1.078244CONNECTICUTYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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