Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ethan Andrew Mack, MD, PHD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1922627843

Dr. Ethan Andrew Mack, MD, PHD is a Pathology in New York, New York. Qualified in 2020, 6 years ago. Practices with Trustees of Columbia University in the City of New York, a 2,250-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

622 W 168th St Ph 1564W
New York, NY 10032-3720
Phone: (212) 305-7399
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 334916 (NY)

Record details

NPI number1922627843
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , PHD
Sole proprietorNo
NPI enumeratedApril 10, 2020
Last updated in NPPESJune 4, 2026
Certification dateJune 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Trustees Of Columbia University In The City Of New York — 2250 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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