Provider Demographics
NPI:1720856776
Name:SUMMER HEALTH MEDICAL GROUP
Entity Type:Organization
Organization Name:SUMMER HEALTH MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF MEDICAL GROUP
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMASCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-338-0567
Mailing Address - Street 1:225 W 86TH ST APT 804
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3332
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 W 86TH ST APT 804
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3332
Practice Address - Country:US
Practice Address - Phone:914-420-3645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMER HEALTH INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty