Individual
MR. CHARLES MARK LIVINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
61 MAIN ST, SUITE 5, GENESEO, NY 14454-1255
(585) 243-7620
(585) 243-1132
Mailing address
42 SOUTH STATE STREET, BOX 418, NUNDA, NY 14517
(585) 468-2867
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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