Provider Demographics
NPI:1134332455
Name:JOSEPH E. CRONKEY, M.D.,P.C.
Entity type:Organization
Organization Name:JOSEPH E. CRONKEY, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:CRONKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-961-1961
Mailing Address - Street 1:1210 O'NEILL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-1709
Mailing Address - Country:US
Mailing Address - Phone:570-961-1961
Mailing Address - Fax:570-504-5016
Practice Address - Street 1:1210 O'NEILL HIGHWAY
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-1709
Practice Address - Country:US
Practice Address - Phone:570-961-1961
Practice Address - Fax:570-504-5016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005553830005Medicaid
PA071884Medicare ID - Type Unspecified
PAB36387Medicare UPIN