Individual
CHARLES SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHARLES SUMMERS
Contact information
Practice address
259 1ST ST, MINEOLA, NY 11501-3957
(516) 663-8312
(516) 663-2184
Mailing address
700 HICKSVILLE RD, SUITE 204, BETHPAGE, NY 11714-3471
(516) 576-6106
(516) 576-5801
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007342-1
NY
Other
Enumeration date
04/19/2008
Last updated
04/19/2008
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