Basic Information
| Provider Information | |||||||||
| NPI: | 1619296951 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CROMER | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | RENEE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2150 CORBIN AVE | ||||||||
| Address2: | |||||||||
| City: | NEW BRITAIN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060532266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8608274751 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4310 LONDONDERRY RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171095333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177912620 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2010 | ||||||||
| LastUpdateDate: | 07/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.