Provider Demographics
NPI:1760821912
Name:CRONIN, SCOTT CHRISTOPHER (PT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:CHRISTOPHER
Last Name:CRONIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BROOKSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:ELMIRA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:14903-9387
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24 BROOKSIDE CIR
Practice Address - Street 2:
Practice Address - City:ELMIRA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:14903-9387
Practice Address - Country:US
Practice Address - Phone:607-742-3272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013311-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist