=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083747463
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUMMIT HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2007
-----------------------------------------------------
Last Update Date | 05/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24818 UNION TPKE
-----------------------------------------------------
City | BELLEROSE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11426-1837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-846-4018
-----------------------------------------------------
Fax | 516-727-7676
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 24818 UNION TPKE
-----------------------------------------------------
City | BELLEROSE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11426-1837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-328-9797
-----------------------------------------------------
Fax | 516-352-6579
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN/EVP
-----------------------------------------------------
Name | DR. DANIEL FROGEL
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 646-549-7334
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207UN0903X
-----------------------------------------------------
Taxonomy Name | In Vivo & In Vitro Nuclear Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------