Healthcare Provider Details

I. General information

NPI: 1922136258
Provider Name (Legal Business Name): AMY CRONISTER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CHESTNUT ST SUITE 1250
PHILADELPHIA PA
19107-4414
US

IV. Provider business mailing address

9042 N ARROYA VISTA DR
PHOENIX AZ
85028-5305
US

V. Phone/Fax

Practice location:
  • Phone: 215-351-2331
  • Fax:
Mailing address:
  • Phone: 602-493-8464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: