Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 178449 | NY |
NPI | 1407884471 |
---|---|
Provider Name | Dr. David Andrew Krusch |
First Address | Rochester, NY 14642-8410 |
Second Address | Rochester, NY 14642-8410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 01/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01135386 | (05) | NY |
E16826 | (02) |