Provider Demographics
NPI:1104096106
Name:KRONBICHLER, KATHLEEN (ANP-C)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:KRONBICHLER
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N VILLAGE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1000
Mailing Address - Country:US
Mailing Address - Phone:516-256-3975
Mailing Address - Fax:516-256-1644
Practice Address - Street 1:1000 N VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1000
Practice Address - Country:US
Practice Address - Phone:516-256-3975
Practice Address - Fax:516-256-1644
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305271-1363LA2200X
FLARNP9201061363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF305271-1OtherSTATE OF NY EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS
NYF305271-1OtherSTATE OF NY EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS