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General NPI Number Information
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NPI Number | 1609543362
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Entity Type | Individual
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Provider Name | JEAN G KROMER
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 10B MADISON AVENUE EXT
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City | ALBANY
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State | NY
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Zip | 12203-7314
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Country | US
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Telephone | 518-867-3061
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Fax |
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Provider Business Mailing Address
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Address Line | 43 LIBERTY WAY
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City | CLIFTON PARK
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State | NY
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Zip | 12065-6779
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Country | US
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Telephone | 518-424-2791
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 010764
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 010764
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License Number State | NY
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