Provider Demographics
NPI:1003999525
Name:KRONWITH, STEPHEN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DAVID
Last Name:KRONWITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:173 MINEOLA BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2528
Mailing Address - Country:US
Mailing Address - Phone:516-747-1850
Mailing Address - Fax:516-747-1857
Practice Address - Street 1:173 MINEOLA BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2528
Practice Address - Country:US
Practice Address - Phone:516-747-1850
Practice Address - Fax:516-747-1857
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2014-06-13
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Provider Licenses
StateLicense IDTaxonomies
NY162659207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD93249Medicare UPIN
NY00246075Medicaid
NYD93249Medicare UPIN