Provider Demographics
NPI:1063597151
Name:CHRONLEY, DAVID J (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:CHRONLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4979 TOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-2283
Mailing Address - Country:US
Mailing Address - Phone:401-789-6492
Mailing Address - Fax:401-789-5524
Practice Address - Street 1:4979 TOWER HILL RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-2283
Practice Address - Country:US
Practice Address - Phone:401-789-6492
Practice Address - Fax:401-789-5524
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI04859208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI404211OtherTUFTS
RI12-00102OtherUNITED HEALTHCARE
RI1694OtherBLUE CROSS/BLUE SHIELD
RI000460OtherBC/BS BLUE CHIP
RIDC02277Medicaid
RI404211OtherTUFTS
RI12-00102OtherUNITED HEALTHCARE