Provider Demographics
NPI:1578237228
Name:CRONIN, NICHOLAS WILLIAM
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:WILLIAM
Last Name:CRONIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MARY AVE
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-9579
Mailing Address - Country:US
Mailing Address - Phone:207-710-7339
Mailing Address - Fax:
Practice Address - Street 1:10 MARY AVE
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-9579
Practice Address - Country:US
Practice Address - Phone:207-710-7339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist