Provider Demographics
NPI:1427093525
Name:KRONMAN, ANDREA CAMEL (MD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CAMEL
Last Name:KRONMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 INDEPENDANCE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467
Mailing Address - Country:US
Mailing Address - Phone:617-541-6560
Mailing Address - Fax:617-541-7503
Practice Address - Street 1:291 INDEPENDANCE DRIVE
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467
Practice Address - Country:US
Practice Address - Phone:617-541-6560
Practice Address - Fax:617-541-7503
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150093207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3170748Medicaid
MAG52194Medicare UPIN
MA3170748Medicaid