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General NPI Number Information
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NPI Number | 1821654559
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Entity Type | Individual
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Provider Name | ADAM RUSSELL KRONISH MD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 55 FRUIT ST
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City | BOSTON
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State | MA
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Zip | 02114-2696
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Country | US
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Telephone | 617-724-4260
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Fax |
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Provider Business Mailing Address
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Address Line | 233 PLEASANT ST # B310
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City | WATERTOWN
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State | MA
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Zip | 02472-2457
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD478630
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 1023604
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License Number State | MA
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