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Individual

DR. VIRGINIA SUMMERVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
20702 42ND AVE, BAYSIDE, NY 11361-2616
(718) 225-3565
Mailing address
20702 42ND AVE, BAYSIDE, NY 11361-2616
(718) 225-3565

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
245093
NY

Other

Enumeration date
05/17/2007
Last updated
12/26/2012
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