1396784849 NPI number — DR. FLORENCE GABRIELLE SUMMERS DPM

Table of content: DR. FLORENCE GABRIELLE SUMMERS DPM (NPI 1396784849)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396784849 NPI number — DR. FLORENCE GABRIELLE SUMMERS DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUMMERS
Provider First Name:
FLORENCE
Provider Middle Name:
GABRIELLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396784849
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/31/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
243 NORTH RD STE 304
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POUGHKEEPSIE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12601-1173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-471-9410
Provider Business Mailing Address Fax Number:
845-471-7372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
696 DUTCHESS TPKE STE M
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POUGHKEEPSIE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12603-6429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-454-0630
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  N005506 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1235164997 . This is a "GROUP PRACTICE NPI NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1793757 . This is a "UNITED HEALTHCARE LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 408871001 . This is a "BSNENY GROUP LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30061 . This is a "LAST 5 TIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 33D0164140 . This is a "CLIA IDENTIFIER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200053170 . This is a "MVP HEALTH PLAN GROUP LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5C8019 . This is a "PHS LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 86149 . This is a "GHI HMO SELECT LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: CJ2100 . This is a "RAILROAD MEDICARE GROUP LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: FS0PH59410 . This is a "EMPIRE BLUE CROSS BLUE SHIELD LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000416689002 . This is a "BSNENY LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0497739 . This is a "CIGNA LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10087065 . This is a "CDPHP LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1793757 . This is a "NYS EMPIRE PLAN UHEALTH CARE LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2702517 . This is a "EVERCARE LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 394648 . This is a "MVP HEALTH PLAN LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1831772 . This is a "CIGNA LEGACY NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6202446 . This is a "GHI LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3208416 . This is a "OXFORD HEALTHCARE LEGACY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02004713 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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