Provider Demographics
NPI:1790532133
Name:JILL M CRONIN MSPT INC
Entity type:Organization
Organization Name:JILL M CRONIN MSPT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:CRONIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:914-384-0450
Mailing Address - Street 1:12 RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:PURDYS
Mailing Address - State:NY
Mailing Address - Zip Code:10578-1404
Mailing Address - Country:US
Mailing Address - Phone:914-384-0450
Mailing Address - Fax:
Practice Address - Street 1:12 RIDGE WAY
Practice Address - Street 2:
Practice Address - City:PURDYS
Practice Address - State:NY
Practice Address - Zip Code:10578-1404
Practice Address - Country:US
Practice Address - Phone:914-384-0450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty