Healthcare Provider Details

I. General information

NPI: 1619979697
Provider Name (Legal Business Name): DAVID F KRONN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 GRASSLANDS RD STE 200
VALHALLA NY
10595-1503
US

IV. Provider business mailing address

503 GRASSLANDS RD STE 200
VALHALLA NY
10595-1503
US

V. Phone/Fax

Practice location:
  • Phone: 914-304-5280
  • Fax: 914-345-1755
Mailing address:
  • Phone: 914-304-5280
  • Fax: 914-345-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number193350
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number193350
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier001367186
Identifier TypeMEDICAID
Identifier StateCT
Identifier Issuer
# 2
Identifier01677292
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: