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General NPI Number Information
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NPI Number | 1578859195
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Entity Type | Organization
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Legal Business Name | CHARLES J KRONENGOLD, M.D., P.A.
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 22 OLD SHORT HILLS RD STE 111
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5605
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Country | US
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Telephone | 973-992-5005
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Fax | 973-992-5024
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Provider Business Mailing Address
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Address Line | 22 OLD SHORT HILLS RD STE 111
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5605
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Country | US
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Telephone | 973-992-5005
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Fax | 973-992-5024
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CHARLES J KRONENGOLD
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Credential | M.D.
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Telephone | 973-992-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1100X
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Taxonomy Name | Ophthalmic Technician/Technologist
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License Number | 25MA02885900
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License Number State | NJ
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