Healthcare Provider Details

I. General information

NPI: 1659696250
Provider Name (Legal Business Name): NICHOLAS JOSEPH CROGNALE D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 S WEST END BLVD
QUAKERTOWN PA
18951-1140
US

IV. Provider business mailing address

306 MILL RIDGE DR
CHALFONT PA
18914-2115
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-1735
  • Fax:
Mailing address:
  • Phone: 215-450-5298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberOS017000
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: