Individual
DR. CONNIE L CHRONISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1200 W GODFREY AVE, PHILADELPHIA, PA 19141-3323
(215) 276-6000
Mailing address
1246 SUSQUEHANNA RD, RYDAL, PA 19046-1825
(215) 884-1153
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001004
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AETNA HMO
HMO
PA
01
—
BLUE SHIELD
BLUE SHIELD
PA
Enumeration date
08/04/2006
Last updated
02/29/2012
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