Provider Demographics
NPI:1083747463
Name:SUMMIT HEALTH
Entity Type:Organization
Organization Name:SUMMIT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/EVP
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FROGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-549-7334
Mailing Address - Street 1:24818 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-1837
Mailing Address - Country:US
Mailing Address - Phone:516-328-9797
Mailing Address - Fax:516-352-6579
Practice Address - Street 1:24818 UNION TPKE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1837
Practice Address - Country:US
Practice Address - Phone:516-846-4018
Practice Address - Fax:516-727-7676
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT MEDICAL GROUP PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-14
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207R00000X, 207RC0000X, 207UN0903X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207UN0903XAllopathic & Osteopathic PhysiciansNuclear MedicineIn Vivo & In Vitro Nuclear MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW22061Medicare PIN