Provider Demographics
NPI:1326390436
Name:KRONEMBERG, JANET (REGISTER VASCULAR SP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:KRONEMBERG
Suffix:
Gender:F
Credentials:REGISTER VASCULAR SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 ACKERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-3845
Mailing Address - Country:US
Mailing Address - Phone:631-463-3747
Mailing Address - Fax:
Practice Address - Street 1:411 LAFAYETTE ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-7035
Practice Address - Country:US
Practice Address - Phone:631-969-6683
Practice Address - Fax:631-968-2401
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000814642471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography