Provider Demographics
NPI:1972173300
Name:NESTOROWICZ, SUMMER CHRISTINE (MD)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:CHRISTINE
Last Name:NESTOROWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:CHRISTINE
Other - Last Name:OVERHOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:130 S 9TH ST STE 2300
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5233
Mailing Address - Country:US
Mailing Address - Phone:215-955-8388
Mailing Address - Fax:
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-730-8132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT222967208100000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation