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Individual
MR. CHARLES MARK LIVINGSTON
Active
Individual
MR. CHARLES MARK LIVINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
23-004586
NY
363AM0700X
Medical Physician Assistant
23004586
NY
363AS0400X
Surgical Physician Assistant
Primary
23004586
NY
Other
Enumeration date
09/05/2006
Last updated
09/11/2025
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