Provider Demographics
NPI:1376511519
Name:MCCRONE, ELCINDA L (MD)
Entity Type:Individual
Prefix:
First Name:ELCINDA
Middle Name:L
Last Name:MCCRONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 847348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-7348
Mailing Address - Country:US
Mailing Address - Phone:508-828-6733
Mailing Address - Fax:508-828-6736
Practice Address - Street 1:1 WASHINGTON ST
Practice Address - Street 2:INFECTIOUS DISEASE
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3960
Practice Address - Country:US
Practice Address - Phone:508-828-6733
Practice Address - Fax:508-828-6736
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA55839207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3054004Medicaid
F05034Medicare UPIN
MA3054004Medicaid