Provider Demographics
NPI:1396784849
Name:SUMMERS, FLORENCE GABRIELLE (DPM)
Entity type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:GABRIELLE
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 NORTH RD STE 304
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1173
Mailing Address - Country:US
Mailing Address - Phone:845-471-9410
Mailing Address - Fax:845-471-7372
Practice Address - Street 1:696 DUTCHESS TPKE STE M
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-6429
Practice Address - Country:US
Practice Address - Phone:845-454-0630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005506213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1235164997OtherGROUP PRACTICE NPI NUMBER
1793757OtherUNITED HEALTHCARE LEGACY NUMBER
408871001OtherBSNENY GROUP LEGACY NUMBER
30061OtherLAST 5 TIN
33D0164140OtherCLIA IDENTIFIER
200053170OtherMVP HEALTH PLAN GROUP LEGACY NUMBER
5C8019OtherPHS LEGACY NUMBER
86149OtherGHI HMO SELECT LEGACY NUMBER
CJ2100OtherRAILROAD MEDICARE GROUP LEGACY NUMBER
FS0PH59410OtherEMPIRE BLUE CROSS BLUE SHIELD LEGACY NUMBER
000416689002OtherBSNENY LEGACY NUMBER
0497739OtherCIGNA LEGACY NUMBER
10087065OtherCDPHP LEGACY NUMBER
1793757OtherNYS EMPIRE PLAN UHEALTH CARE LEGACY NUMBER
2702517OtherEVERCARE LEGACY NUMBER
394648OtherMVP HEALTH PLAN LEGACY NUMBER
NY1831772OtherCIGNA LEGACY NUMBER
6202446OtherGHI LEGACY NUMBER
P3208416OtherOXFORD HEALTHCARE LEGACY NUMBER
NY02004713Medicaid
109052400OtherGOVERNMENT WORKERS COMP LEGACY NUMBER
244466OtherWELLCARE LEGACY NUMBER
7065094OtherAETNA HEALTHCARE LEGACY NUMBER
PH594PAE21Medicare PIN
0497739OtherCIGNA LEGACY NUMBER
10087065OtherCDPHP LEGACY NUMBER
NY1831772OtherCIGNA LEGACY NUMBER
5C8019OtherPHS LEGACY NUMBER