Healthcare Provider Details

I. General information

NPI: 1952727208
Provider Name (Legal Business Name): KAYLA PAIGE SOMMER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAYLA PAIGE BIRNBAUM PA

II. Dates (important events)

Enumeration Date: 03/11/2014
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COMMUNITY DR
MANHASSET NY
11030-3816
US

IV. Provider business mailing address

300 COMMUNITY DR
MANHASSET NY
11030-3816
US

V. Phone/Fax

Practice location:
  • Phone: 516-316-8275
  • Fax:
Mailing address:
  • Phone: 516-316-8275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number017445
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: