Organization
CROUSE MEDICAL PRACTICE PLLC
Active
Parent organization
CROUSE MEDICAL PRACTICE PLLC
Other names
Sports Care Express
Organization subpart
Yes
Provider details
NPI number
Legal business name
CROUSE MEDICAL PRACTICE PLLC
Authorized official
PAUL KRONENBERG MD (SOLE SHAREHOLDER)
(315) 470-7825
Entity
Organization
Contact information
Practice address
5823 WIDEWATERS PKWY, EAST SYRACUSE, NY 13057-3081
(315) 474-6824
Mailing address
PO BOX 91004, ROCHESTER, NY 14692-9104
(315) 446-3904
(315) 552-6590
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/24/2012
Last updated
07/24/2012
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