Provider Demographics
NPI:1609986025
Name:CRONIN, TERRENCE RAINFORD (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:RAINFORD
Last Name:CRONIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 WINSLOW AVE # MLC10001
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1144
Mailing Address - Country:US
Mailing Address - Phone:513-636-4366
Mailing Address - Fax:513-636-0516
Practice Address - Street 1:2800 WINSLOW AVE # MLC10001
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1144
Practice Address - Country:US
Practice Address - Phone:513-636-4366
Practice Address - Fax:513-636-0516
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132562208000000X, 2080S0010X
WAMD6005114208000000X
WAMD600511042080S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A744140Medicaid
CA00A744140Medicaid
CAH60191Medicare UPIN