Provider Demographics
NPI:1164863320
Name:SUMMIT MEDICAL CARE P.C.
Entity Type:Organization
Organization Name:SUMMIT MEDICAL CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:914-747-9100
Mailing Address - Street 1:500 SUMMIT LAKE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1340
Mailing Address - Country:US
Mailing Address - Phone:914-747-9100
Mailing Address - Fax:914-747-8100
Practice Address - Street 1:500 SUMMIT LAKE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1340
Practice Address - Country:US
Practice Address - Phone:914-747-9100
Practice Address - Fax:914-747-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246031208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty