Provider Demographics
NPI:1093783789
Name:CANN, DAVID F (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:CANN
Suffix:
Gender:M
Credentials:CRNA
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:99 EAST STATE STREET
Mailing Address - Street 2:NATHAN LITTAUER HOSPITAL
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-0010
Mailing Address - Country:US
Mailing Address - Phone:518-773-5559
Mailing Address - Fax:518-773-5601
Practice Address - Street 1:99 EAST STATE STREET
Practice Address - Street 2:NATHAN LITTAUER HOSPITAL
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-0010
Practice Address - Country:US
Practice Address - Phone:518-773-5559
Practice Address - Fax:518-773-5601
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF430629363LA2100X
NY507850367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ02901Medicare UPIN
NYRA0240Medicare ID - Type Unspecified