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General NPI Number Information
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NPI Number | 1487749073
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Entity Type | Organization
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Legal Business Name | CHUCK LIVINGSTON PA PLLC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 61 MAIN ST SUITE 5
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City | GENESEO
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State | NY
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Zip | 14454
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Country | US
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Telephone | 585-243-7620
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Fax | 585-243-1132
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Provider Business Mailing Address
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Address Line | 61 MAIN ST SUITE 5
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City | GENESEO
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State | NY
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Zip | 14454
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Country | US
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Telephone | 585-243-7620
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Fax | 585-243-1132
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES M LIVINGSTON
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Credential | PA
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Telephone | 585-243-7620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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