Provider Demographics
NPI:1386685857
Name:CRONIN, ANANDA (NP)
Entity Type:Individual
Prefix:
First Name:ANANDA
Middle Name:
Last Name:CRONIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 PRESTON AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4491
Mailing Address - Country:US
Mailing Address - Phone:434-227-5624
Mailing Address - Fax:434-970-7700
Practice Address - Street 1:901 PRESTON AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4491
Practice Address - Country:US
Practice Address - Phone:434-227-5624
Practice Address - Fax:434-970-7700
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164065207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007793111Medicaid
VAQ65766Medicare UPIN