Provider Demographics
NPI:1477618056
Name:SUMNER, PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:SUMNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 EAST JERICHO TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2032
Mailing Address - Country:US
Mailing Address - Phone:516-248-6262
Mailing Address - Fax:516-294-9875
Practice Address - Street 1:181 EAST JERICHO TURNPIKE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2032
Practice Address - Country:US
Practice Address - Phone:516-248-6262
Practice Address - Fax:516-294-9875
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075820207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B14462Medicare UPIN
428131Medicare ID - Type Unspecified