Provider Demographics
NPI:1609159151
Name:CRONIN, PAMELA (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:CRONIN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-1573
Mailing Address - Country:US
Mailing Address - Phone:978-524-9934
Mailing Address - Fax:
Practice Address - Street 1:25 STOREY AVE
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-1869
Practice Address - Country:US
Practice Address - Phone:978-462-0709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21455183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist