Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivan Mak

Individual provider Athletic Trainer · NPI 1649870569

Ivan Mak is an Athletic Trainer in Bayside, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2020
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Practice location Address checks out

22205 56th Ave
Bayside, NY 11364-1432
Phone: (718) 281-5191
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 002005-1 (NY)

Record details

NPI number1649870569
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 29, 2020
Last updated in NPPESOctober 29, 2020
Certification dateOctober 26, 2020
Mailing address222-19 B 69 Ave., Oakland Gardens, NY 11364

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