MEDICARE: ELLEN E. CRONIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	D0012805	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699753475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN E. CRONIN M.D.

Provider Business Mailing Address
First Line	:	4401 E WEST HWY
Second Line	:	SUITE 202
City	:	BETHESDA
State	:	MD
Zip	:	20814-4523
Country	:	US
Telephone Number	:	301-907-3353
Fax Number	:	301-907-8547

Provider Business Practice Location Address
First Line	:	4401 E WEST HWY
Second Line	:	SUITE 202
City	:	BETHESDA
State	:	MD
Zip	:	20814-4523
Country	:	US
Telephone Number	:	301-907-3353
Fax Number	:	301-907-8547

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	07/08/2007

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