Provider Demographics
NPI:1346379823
Name:BROOKS, RICHARD DENNISON (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DENNISON
Last Name:BROOKS
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Gender:M
Credentials:RPA-C
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Mailing Address - Street 1:111 CLARA BARTON ST
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-9503
Mailing Address - Country:US
Mailing Address - Phone:585-335-4344
Mailing Address - Fax:585-991-6020
Practice Address - Street 1:50 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1300
Practice Address - Country:US
Practice Address - Phone:585-243-9595
Practice Address - Fax:585-991-6020
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY005987363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant