Provider Demographics
NPI:1518100429
Name:CRONSELL, JENNIFER L (DO)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:CRONSELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01119-1619
Mailing Address - Country:US
Mailing Address - Phone:413-794-3233
Mailing Address - Fax:
Practice Address - Street 1:280 CHESTNUT ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01199-1619
Practice Address - Country:US
Practice Address - Phone:413-794-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250892207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine