Doctor Name: | DARYL KROUSE |
NPI Number: | 1245462696 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 340 Montage Mountain Rd Moosic, PA - 185071782 |
Business Phone Number: | 5703449266 |
Business Fax Number: | 5703441085 |
Mailing Address: | 340 Montage Mountain Rd, MOOSIC |
State: | PA |
Postal Code: | 185071782 |
Phone Number: | 5703449266 |
Fax Number: | 5703441085 |
NPI Enumeration Date: | 08/19/2009 |
NPI Last Update Date: | 08/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |