National Provider Identifier
Charles Mark Livingston, PA
Charles Mark Livingston, PA is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Geneseo, NY and a listed phone number of (585) 243-7620.
Profile Overview
- NPI
- 1174625537
- Provider Type
- Individual
- Primary Specialty
- Surgical Physician Assistant
- Enumeration Date
- September 05, 2006
- Last Updated
- September 11, 2025
Practice Location
- 61 Main St
- Suite 5
- Geneseo, NY 14454-1255
Phone: (585) 243-7620
Mailing Address
- 42 South State Street
- Box 418
- Nunda, NY 14517
Specialties
- Surgical Physician Assistant (363AS0400X)
- Medical Physician Assistant (363AM0700X)
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1174625537
- Entity Type
- Individual
- Last Name
- Livingston
- First Name
- Charles
- Middle Name
- Mark
- Name Prefix
- Mr.
- Credential
- PA
- Mailing Street Address
- 42 South State Street
- Mailing Address Line 2
- Box 418
- Mailing City
- Nunda
- Mailing State
- NY
- Mailing ZIP Code
- 14517
- Mailing Country
- US
- Mailing Phone
- (585) 468-2867
- Practice Street Address
- 61 Main St
- Practice Address Line 2
- Suite 5
- Practice City
- Geneseo
- Practice State
- NY
- Practice ZIP Code
- 14454-1255
- Practice Country
- US
- Practice Phone
- (585) 243-7620
- Practice Fax
- (585) 243-1132
- Enumeration Date
- September 05, 2006
- Last Updated
- September 11, 2025
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Surgical Physician Assistant (363AS0400X), Medical Physician Assistant (363AM0700X), Physician Assistant (363A00000X)