Provider Demographics
NPI:1205261823
Name:CRONIN, JAMIE L (MSED)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:CRONIN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MANSION AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1123
Mailing Address - Country:US
Mailing Address - Phone:845-742-5487
Mailing Address - Fax:
Practice Address - Street 1:25 MANSION AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-1123
Practice Address - Country:US
Practice Address - Phone:845-742-5487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY755825131174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist