MEDICARE: MS. CHRISTINA MARIE CROCKER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	030119	NY

General Provider Information

NPI Number	:	1245981489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA MARIE CROCKER PA-C

Provider Business Mailing Address
First Line	:	10869 STATE ROUTE 36
Second Line	:
City	:	DANSVILLE
State	:	NY
Zip	:	14437-9444
Country	:	US
Telephone Number	:	585-335-3100
Fax Number	:	585-335-8695

Provider Business Practice Location Address
First Line	:	50 E SOUTH ST STE 700
Second Line	:
City	:	GENESEO
State	:	NY
Zip	:	14454-1387
Country	:	US
Telephone Number	:	585-243-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2022
Last Update Date	:	12/30/2025

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