Healthcare Provider Details

I. General information

NPI: 1750465670
Provider Name (Legal Business Name): DORIE HANKIN KRONWITH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26910 GRAND CENTRAL PKWY APT 14O
FLORAL PARK NY
11005-1014
US

IV. Provider business mailing address

26910 GRAND CENTRAL PKWY APT 14O
FLORAL PARK NY
11005-1014
US

V. Phone/Fax

Practice location:
  • Phone: 516-509-6642
  • Fax: 347-235-0772
Mailing address:
  • Phone: 516-509-6642
  • Fax: 347-235-0772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number124927-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number124927-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: