Provider Demographics
NPI:1679715205
Name:SOMMER, MICHAEL FRANCIS (RPAC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:SOMMER
Suffix:
Gender:M
Credentials:RPAC
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Mailing Address - Street 1:791 NORTH WELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-1210
Mailing Address - Country:US
Mailing Address - Phone:631-957-2200
Mailing Address - Fax:631-957-4619
Practice Address - Street 1:1235 SUFFOLK AVE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-4511
Practice Address - Country:US
Practice Address - Phone:631-436-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2015-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY013143363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical