Provider Demographics
NPI:1053507392
Name:TRUSEL, DAVID RAMSEY (PA-C)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:RAMSEY
Last Name:TRUSEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14787-1155
Mailing Address - Country:US
Mailing Address - Phone:716-326-4686
Mailing Address - Fax:716-326-4628
Practice Address - Street 1:158 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NY
Practice Address - Zip Code:14787-1155
Practice Address - Country:US
Practice Address - Phone:716-326-4686
Practice Address - Fax:716-326-4628
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001370363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant