Healthcare Provider Details

I. General information

NPI: 1700251378
Provider Name (Legal Business Name): EILEEN M. CRONIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 POMFRET ST
PUTNAM CT
06260-1836
US

IV. Provider business mailing address

281 COUNTY ST
ATTLEBORO MA
02703-3511
US

V. Phone/Fax

Practice location:
  • Phone: 860-928-6541
  • Fax:
Mailing address:
  • Phone: 508-226-2213
  • Fax: 508-431-2637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA5486
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7104
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: