Provider Demographics
NPI:1174629711
Name:CRONIN, BONNIE J (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:J
Last Name:CRONIN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1421
Mailing Address - Country:US
Mailing Address - Phone:585-394-2028
Mailing Address - Fax:
Practice Address - Street 1:343 N MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1072
Practice Address - Country:US
Practice Address - Phone:585-394-3490
Practice Address - Fax:585-394-3567
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002554171100000X
WANT00001206175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath