Healthcare Provider Details

I. General information

NPI: 1972216836
Provider Name (Legal Business Name): KRONOS HEALTH GERIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 MERRIMACK ST STE 9
LAWRENCE MA
01843-1764
US

IV. Provider business mailing address

360 MERRIMACK ST STE 9
LAWRENCE MA
01843-1764
US

V. Phone/Fax

Practice location:
  • Phone: 978-655-6652
  • Fax:
Mailing address:
  • Phone: 978-655-6652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT EARLY
Title or Position: CEO
Credential: MD
Phone: 978-655-6652