Healthcare Provider Details

I. General information

NPI: 1114993599
Provider Name (Legal Business Name): RONALD ANTHONY KROSS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 12/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROCHELLE ST. CITY ISLAND
BRONX NY
10464-1606
US

IV. Provider business mailing address

1 ROCHELLE ST. CITY ISLAND
BRONX NY
10464
US

V. Phone/Fax

Practice location:
  • Phone: 718-885-2037
  • Fax: 718-885-3225
Mailing address:
  • Phone: 718-885-2037
  • Fax: 718-885-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number135710
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number135710
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: