Provider Demographics
NPI:1972546422
Name:SUMMERS, SHEILA T (NP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:T
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HUMBOLDT PKWY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14208-2221
Mailing Address - Country:US
Mailing Address - Phone:716-887-8272
Mailing Address - Fax:
Practice Address - Street 1:1001 HUMBOLDT PKWY
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14208-2221
Practice Address - Country:US
Practice Address - Phone:716-887-8272
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY360110363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P10922Medicare UPIN
BB9734Medicare ID - Type Unspecified