Provider Demographics
NPI:1518947852
Name:KRONBERGER, CARLOS V (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:V
Last Name:KRONBERGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 PRYTANIA ST.
Mailing Address - Street 2:PMB 516
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-4221
Mailing Address - Country:US
Mailing Address - Phone:504-361-3511
Mailing Address - Fax:504-361-3515
Practice Address - Street 1:2401 WESTBEND PKWY
Practice Address - Street 2:STE 3024
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-2465
Practice Address - Country:US
Practice Address - Phone:504-361-3511
Practice Address - Fax:504-361-3515
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA513103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R14721Medicare UPIN
LA5S681Medicare ID - Type UnspecifiedMEDICARE