MEDICARE: TASHIKA MONIQUE SUMMERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	283538	NY

General Provider Information

NPI Number	:	1588527402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TASHIKA MONIQUE SUMMERS

Provider Business Mailing Address
First Line	:	3840 E ROBINSON RD APT 271
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14228-2001
Country	:	US
Telephone Number	:	716-370-5948
Fax Number	:

Provider Business Practice Location Address
First Line	:	3840 E ROBINSON RD APT 271
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14228-2001
Country	:	US
Telephone Number	:	716-370-5948
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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