Provider Demographics
NPI:1811971310
Name:CRONYN, ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:CRONYN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60538
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-0538
Mailing Address - Country:US
Mailing Address - Phone:413-341-9400
Mailing Address - Fax:413-341-9421
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-3160
Practice Address - Country:US
Practice Address - Phone:413-341-9400
Practice Address - Fax:413-341-9421
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012011169208000000X
AZ37482208000000X
MA286660208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ295224Medicaid
AZZ119545Medicare PIN