Healthcare Provider Details

I. General information

NPI: 1962523795
Provider Name (Legal Business Name): BRENDA CRONIN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 DUNSTER ST
CAMBRIDGE MA
02138-5002
US

IV. Provider business mailing address

63 FAIRMONT ST
ARLINGTON MA
02474-8717
US

V. Phone/Fax

Practice location:
  • Phone: 617-354-5590
  • Fax: 617-812-6050
Mailing address:
  • Phone: 617-354-5590
  • Fax: 617-812-6050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3479
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number3479
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number3479
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number3479
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number3479
License Number StateMA
# 6
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License Number3479
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: