MEDICARE: DORIE HANKIN KRONWITH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0006X	Developmental - Behavioral Pediatrics Physician	124927-1	NY
2	2080P0008X	Pediatric Neurodevelopmental Disabilities Physician	124927-1	NY

General Provider Information

NPI Number	:	1750465670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORIE HANKIN KRONWITH M.D.

Provider Business Mailing Address
First Line	:	26910 GRAND CENTRAL PKWY APT 14O
Second Line	:
City	:	FLORAL PARK
State	:	NY
Zip	:	11005-1014
Country	:	US
Telephone Number	:	516-509-6642
Fax Number	:	347-235-0772

Provider Business Practice Location Address
First Line	:	26910 GRAND CENTRAL PKWY APT 14O
Second Line	:
City	:	FLORAL PARK
State	:	NY
Zip	:	11005-1014
Country	:	US
Telephone Number	:	516-509-6642
Fax Number	:	347-235-0772

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	11/09/2020

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