Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD070366-L | PA |
NPI | 1033135918 |
---|---|
Provider Name | Dr. Brian Colum Cronin |
First Address | Willow Grove, PA 19090-1332 |
Second Address | Willow Grove, PA 19090-1332 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 20/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001906590001 | (05) | PA |
02334MD70366L | HEALTH PARTNERS (01) | PA |
1418837 | HIGHMARK BLUE SHIELD (01) | PA |
2105104000 | KEYSYONE (01) | PA |
231952978 | TAX ID (01) | PA |
30001543 | KEYSTONE MERCY (01) | PA |
3507769 | CIGNA (01) | PA |
390008468 | RR MEDICARE (01) | PA |
7114525 | AETNA (01) | PA |
H70805 | (02) |