Provider Demographics
NPI:1376615492
Name:CROOKS, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:CROOKS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3041 ORCHARD PARK RD STE C
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1238
Mailing Address - Country:US
Mailing Address - Phone:716-674-3104
Mailing Address - Fax:716-674-0666
Practice Address - Street 1:199 PARK CLUB LN STE 100
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5269
Practice Address - Country:US
Practice Address - Phone:716-332-6834
Practice Address - Fax:716-332-6856
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2023-01-24
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Provider Licenses
StateLicense IDTaxonomies
NY296535208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001595543Medicaid
PAG33073Medicare UPIN
PA001595543Medicaid