Basic Information
| Provider Information | |||||||||
| NPI: | 1619979697 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRONN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 503 GRASSLANDS RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | VALHALLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105951503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143045280 | ||||||||
| FaxNumber: | 9143451755 | ||||||||
| Practice Location | |||||||||
| Address1: | 503 GRASSLANDS RD | ||||||||
| Address2: | STE 200 | ||||||||
| City: | VALHALLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105951503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143045280 | ||||||||
| FaxNumber: | 9143451755 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 05/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 193350 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | 207SG0201X | 193350 | NY | Y | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) |
ID Information
| ID | Type | State | Issuer | Description | 001367186 | 05 | CT | MEDICAID | 01677292 | 05 | NY | MEDICAID |