Individual
SUMMER FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1 HEROES WAY, RIVERHEAD, NY 11901-2058
(631) 548-6000
Mailing address
15 MOON RD, ROCKY POINT, NY 11778-8619
(631) 943-5857
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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