Provider Demographics
NPI:1457465395
Name:CRESS, DAVID L SR (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:CRESS
Suffix:SR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3300 E VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14418-9520
Mailing Address - Country:US
Mailing Address - Phone:315-595-2728
Mailing Address - Fax:
Practice Address - Street 1:76 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-0810
Practice Address - Country:US
Practice Address - Phone:607-664-4602
Practice Address - Fax:607-664-4605
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000565363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical