Provider Demographics
NPI:1205826484
Name:CRONIN, JONATHAN HILL (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:HILL
Last Name:CRONIN
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL NEW BORN SERVICE FND 442
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-9040
Practice Address - Fax:617-726-9346
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2009-05-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA55219208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ05222OtherBCBS MA
MA3013952Medicaid
MA055219OtherTUFTS HEALTH PLAN
E01859Medicare UPIN
MA3013952Medicaid