Individual provider · Type 1 NPI
Charles Mark Livingston, PA
Surgical Physician Assistant · Geneseo, NY
NPI number
1174625537
Active
Practice location
61 Main St, Suite 5
Geneseo, NY 14454-1255
Fax (585) 243-1132
Mailing address
42 South State Street, Box 418
Nunda, NY 14517
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 23-004586 (NY) |
| Medical Physician Assistant | 363AM0700X | 23004586 (NY) |
| Surgical Physician Assistant Primary | 363AS0400X | 23004586 (NY) |
Surgical Physician Assistant: Definition to come...
2 other providers at this address
About NPI 1174625537
Charles Mark Livingston, PA's National Provider Identifier is 1174625537, issued on Sep 5, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Geneseo, NY. The record was last updated on Sep 11, 2025.