Provider Demographics
NPI:1598731093
Name:KRASON, GLORIA JEAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:JEAN
Last Name:KRASON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013
Mailing Address - Country:US
Mailing Address - Phone:413-594-4747
Mailing Address - Fax:413-594-6746
Practice Address - Street 1:5 SPRING ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013
Practice Address - Country:US
Practice Address - Phone:413-594-4747
Practice Address - Fax:413-594-6746
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA1938213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U03100Medicare UPIN
KRY70927Medicare ID - Type Unspecified