Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. CHARLES MARK LIVINGSTON, PA
Active Sole ProprietorMR. CHARLES MARK LIVINGSTON, PA is a Surgical Physician Assistant healthcare provider located in GENESEO, New York. NPI 1174625537 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · GENESEO, NY
Registration Details
- NPI Number
- 1174625537
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 5, 2006 (19.942378737021 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
23-004586 (NY)23004586 (NY)23004586 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
61 MAIN STSUITE 5GENESEO, NY, 144541255Browse NY providers · Browse ZIP 14454
- Phone
- 5852437620
- Fax
- 5852431132
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Medical Physician Assistant
- Additional Specialty
- Surgical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.