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Organization
SUMMIT AVENUE MEDICAL PA
Active
Organization
SUMMIT AVENUE MEDICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARON B LEVONT (OFFICE MANAGER)
(201) 646-0001
Entity
Organization
Contact information
Practice address
5 SUMMIT AVE, STE 1, HACKENSACK, NJ 07601-8503
(201) 646-0001
(201) 646-9101
Mailing address
5 SUMMIT AVE, STE 1, HACKENSACK, NJ 07601-8503
(201) 646-0001
(201) 646-9101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0127584001
AMERIHEALTH
—
01
—
2514
AETNA US HEALTHCARE
—
01
—
CD1762
RAILROAD MEDICARE
—
Enumeration date
07/12/2005
Last updated
07/21/2022
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