Provider Demographics
NPI:1134155526
Name:CROGNALE, DINO (MD)
Entity type:Individual
Prefix:DR
First Name:DINO
Middle Name:
Last Name:CROGNALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:140 COMMONWEALTH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3629
Mailing Address - Country:US
Mailing Address - Phone:978-762-6262
Mailing Address - Fax:978-750-8312
Practice Address - Street 1:140 COMMONWEALTH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3629
Practice Address - Country:US
Practice Address - Phone:978-762-6262
Practice Address - Fax:978-750-8312
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2010-09-23
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Provider Licenses
StateLicense IDTaxonomies
MA204747207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA31456Medicare ID - Type Unspecified