Organization
CROUSE MEDICAL PRACTICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL KRONENBERG M.D. (MEMBER)
(315) 470-7375
Entity
Organization
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7375
Mailing address
730 S CROUSE AVE, SUITE 204, SYRACUSE, NY 13210-1754
(315) 470-7864
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207T00000X
Neurological Surgery Physician
—
—
208800000X
Urology Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03226395
—
NY
Enumeration date
03/04/2010
Last updated
09/17/2010
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